• 1

    Havlickova B, Czaika VA, Friedrich M: Epidemiological trends in skin mycoses worldwide. Mycoses 51(suppl 4): 2, 2008.

  • 2

    Gupta AK, Studholme C: Novel investigational therapies for onychomycosis: an update. Expert Opin Investig Drugs 25: 297, 2016.

  • 3

    Tosti A, Piraccini BM, Stinchi C: Relapses of onychomycosis after successful treatment with systemic antifungals: a three-year follow-up. Dermatology 197: 162, 1998.

  • 4

    Ghannoum MA, Isham N, Long L: Optimization of an infected shoe model for the evaluation of an ultraviolet shoe sanitizer device. J Am Podiatr Med Assoc 102: 309, 2012.

  • 5

    Messina G, Burgassi S, Russo C, et al: Is it possible to sanitize athletes' shoes? J Athl Train 50: 126, 2015.

  • 6

    Broughton RH: Reinfection from socks and shoes in tinea pedis. Br J Dermatol 67: 249, 1955.

  • 7

    Ara K, Hama M, Akiba S, et al: Foot odor due to microbial metabolism and its control. Can J Microbiol 52: 357, 2006.

  • 8

    Warshaw E, Ahmed D: Are mothballs helpful in preventing onychomycosis reinfection? Arch Dermatol 135: 1120, 1999.

  • 9

    Jamieson R, McCrea A: Shoes: a source of reinfection in ringworm of the feet. Arch Dermatol 35: 203, 1937.

  • 10

    Bender S, Bomba B, O'Quinn S, et al: Is it really athlete's foot? Patient Care 3: 128, 1969.

  • 11

    Cronin LJ, Mildren RP, Moffitt M, et al: An investigation into the inhibitory effect of ultraviolet radiation on Trichophyton rubrum. Lasers Med Sci 29: 157, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Dixon HA: The study of fungi in diseases of the skin. Can Med Assoc J 14: 1097, 1924.

  • 13

    Jamieson R, McCrea A: Ringworm of the feet: shoes and slippers as a source of reinfection. Arch Dermatol 44: 837, 1941.

  • 14

    Gupta AK, Brintnell WC: Sanitization of contaminated footwear from onychomycosis patients using ozone gas: a novel adjunct therapy for treating onychomycosis and tinea pedis? J Cutan Med Surg 17: 243, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Ajello L, Getz ME: Recovery of dermatophytes from shoes and shower stalls. J Invest Dermatol 22: 17, 1954.

  • 16

    Tanaka K, Katoh T, Irimajiri J, et al: Preventive effects of various types of footwear and cleaning methods on dermatophyte adhesion. J Dermatol 33: 528, 2006.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Bonifaz A, Vázquez-González D, Hernández MA, et al: Dermatophyte isolation in the socks of patients with tinea pedis and onychomycosis. J Dermatol 40: 504, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Bonar L, Dreyer AD: Studies on ringworm funguses with reference to public health problems. Am J Public Health Nations Health 22: 909, 1932.

  • 19

    Rosenthal SA, Baer RL, Litt JZ, et al: Studies on the dissemination of fungi from the feet of subjects with and without fungous disease of the feet. J Invest Dermatol 26: 41, 1956.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Berberian D: Dermatophytosis of the feet: sources and methods of prevention of reinfection. Arch Dermatol 38: 367, 1938.

  • 21

    Hammer TR, Mucha H, Hoefer D: Infection risk by dermatophytes during storage and after domestic laundry and their temperature-dependent inactivation. Mycopathologia 171: 43, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Amichai B, Grunwald MH, Davidovici B, et al: “Sunlight is said to be the best of disinfectants”*: the efficacy of sun exposure for reducing fungal contamination in used clothes. Isr Med Assoc J 16: 431, 2014.

    • Search Google Scholar
    • Export Citation
  • 23

    Hijnen WA, Beerendonk EF, Medema GJ: Inactivation credit of UV radiation for viruses, bacteria and protozoan (oo)cysts in water: a review. Water Res 40: 3, 2006.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Reed NG: The history of ultraviolet germicidal irradiation for air disinfection. Public Health Rep 125: 15, 2010.

  • 25

    Watanabe K, Taniguchi H, Nishioka K, et al: Preventive effects of various socks against adhesion of dermatophytes to healthy feet [in Japanese]. Nihon Ishinkin Gakkai Zasshi 41: 183, 2000.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Shirakawa M: Experimental studies on the application of some bactericides and fungicides from the viewpoint of clothes sanitation III. On the effects of pentachlorophenol mixed in the insoles of canvas shoes to various bacteria and eumycetes. Kurume Med J 6: 111, 1959.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27

    Shirakawa M: Experimental studies on the application of some bactericides and fungicides from the viewpoint of clothes sanitation. Kurume Med J 6: 41, 1959.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28

    Hammer TR, Mucha H, Hoefer D: Dermatophyte susceptibility varies towards antimicrobial textiles. Mycoses 55: 344, 2012.

  • 29

    Borkow G, Gabbay J: Biocidal textiles can help fight nosocomial infections. Med Hypotheses 70: 990, 2008.

  • 30

    Colborn T, Vom Saal F, Soto A: Developmental effects of endocrine-disrupting chemicals in wildlife and humans. Env Health Perspect 101: 378, 1993.

  • 31

    Gupta AK, Ahmad I, Summerbell RC: Comparative efficacies of commonly used disinfectants and antifungal pharmaceutical spray preparations against dermatophytic fungi. Med Mycol 39: 321, 2001.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    English MP, Wethered RR, Duncan EH: Studies in the epidemiology of tinea pedis: VIII. Fungal infection in a long-stay hospital. Br Med J 3: 136, 1967.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33

    Amichai B, Grunwald MH, Davidovici B, et al: The effect of domestic laundry processes on fungal contamination of socks. Int J Dermatol 52: 1392, 2013.

  • 34

    Ossowski B, Duchmann U: Effect of domestic laundry processes on mycotic contamination of textiles [in German]. Hautarzt 48: 397, 1997.

  • 35

    Orr KE, Holliday MG, Jones AL, et al: Survival of enterococci during hospital laundry processing. J Hosp Infect 50: 133, 2002.

  • 36

    Fijan S, Sostar-Turk S, Cencic A: Implementing hygiene monitoring systems in hospital laundries in order to reduce microbial contamination of hospital textiles. J Hosp Infect 61: 30, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Jung WK, Kim SH, Koo HC, et al: Antifungal activity of the silver ion against contaminated fabric. Mycoses 50: 265, 2007.

  • 38

    He J, Moriya Y, Oketa T, et al: Inactivation mechanism of microorganisms by the synergy of silver and light irradiation, and the application in household electrical appliances [in Chinese]. Sheng Wu Gong Cheng Xue Bao 24: 1091, 2008.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39

    Brunton WA: Infection and hospital laundry. Lancet 345: 1574, 1995.

  • 40

    Gupta AK, Brintnell W: Ozone gas effectively kills laboratory strains of Trichophyton rubrum and Trichophyton mentagrophytes using an in vitro test system. J Dermatol Treat 25: 251, 2014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41

    Tang X, Bai Y, Duong A, et al: Formaldehyde in China: production, consumption, exposure levels, and health effects. Environ Int 35: 1210, 2009.

  • 42

    Lutz EA, Sharma S, Casto B, et al: Effectiveness of UV-C equipped vacuum at reducing culturable surface-bound microorganisms on carpets. Environ Sci Technol 44: 9451, 2010.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43

    Kim SO, Ha JW, Park KH, et al: Infrared sensor-based aerosol sanitization system for controlling Escherichia coli O157:H7, Salmonella typhimurium, and Listeria monocytogenes on fresh produce. J Food Prot 77: 977, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44

    Archer-Dubon C, Orozco-Topete R, Leyva-Santiago J, et al: Superficial mycotic infections of the foot in a native pediatric population: a pathogenic role for Trichosporon cutaneum? Pediatr Dermatol 20: 299, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45

    Rush-Munro FM, Black H, Dingley JM: Onychomycosis caused by fusarium oxysporum. Australas J Dermatol 12: 18, 1971.

  • 46

    Gupta AK, Elewski BE, Rosen T, et al: Onychomycosis: strategies to minimize recurrence. J Drugs Dermatol 15: 279, 2016.

  • 47

    Shirakawa M: Experimental studies on the application of some bactericides and fungicides from the viewpoint of clothes sanitation V: on the mildew resistance of canvas raincoat impregnated with pentachlorophenol. Kurume Med J 7: 13, 1960.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48

    Borkow G, Mellibovsky JC: Resolution of skin maladies of the trapped Chilean miners: the unplanned underground copper-impregnated antifungal socks “trial.” Arch Dermatol 148: 134, 2012.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

The Role of Shoe and Sock Sanitization in the Management of Superficial Fungal Infections of the Feet

Aditya K. Gupta Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada.
Mediprobe Research, Inc., London, Ontario, Canada.

Search for other papers by Aditya K. Gupta in
Current site
Google Scholar
PubMed
Close
 MD, PhD
and
Sarah G. Versteeg Mediprobe Research, Inc., London, Ontario, Canada.

Search for other papers by Sarah G. Versteeg in
Current site
Google Scholar
PubMed
Close
 MSc
Restricted access

Because of the ubiquitous nature of dermatophytes and a lack of an adaptive immune response in the nail plate, recurrence and relapse rates associated with superficial fungal infections are high (10%–53%). Cured or improved dermatophytosis patients could become reinfected if exposed to fungal reservoirs, such as an infected shoe, sock, or textile. To prevent this, footwear, sock, and textile sanitization methods can be used. To provide insight into effective sanitization options, the focus of this article is to review footwear, sock, and textile sanitization studies conducted throughout history (1920–2016). Thirty-three studies are covered in this review, encompassing techniques ranging from formaldehyde fumigation and foot powder application, to more modern approaches such as UV light and silver-light irradiation technologies. Older sanitization methods (eg, boiling, use of chlorine and salts) are quite limited in their practicality, as they can result in health complications and ruin shoe integrity. Newer approaches to shoe and sock sanitization, such as ozone application and UV irradiation, have shown very promising results. Further research is still needed with these modern techniques, as knowledge gaps and cost prevent the creation of standardized parameters for successful use. By combining sanitization methods with other preventative measures, protection against reinfection may be enhanced.

Corresponding author: Aditya K. Gupta, MD, PhD, 645 Windermere Road, London, Ontario N5X 2P1, Canada. (E-mail: agupta@execulink.com)