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Tinea pedis

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VOL: 100, ISSUE: 30, PAGE NO: 33


- Tinea pedis is commonly referred to as athlete’s foot.



- It is a common superficial fungal infection of the skin.



- It is most often caused by Trichophyton rubrum, Trichophyton mentagrophytes or Epidermophyton floccosum.



- It mainly affects the warm, moist, unventilated areas between the toes.



- It can vary in severity from mild, chronic and scaling to acute, exfoliative, pustular and bullous.



- Itching.



- White scaling of the skin.



- Internationally tinea pedis is thought to be the world’s most common dermatophytosis.



- 70 per cent of the global population will be infected with tinea pedis at some time.



- It is no more common in any one racial or ethnic group.



- It more commonly affects males than females.



- The prevalence increases with age with most cases occurring after the onset of puberty.



- Tinea pedis is rare in children.



- Diagnosis can be made by visual examination only.



- In cases where diagnosis is in doubt or treatment has not been effective, a skin scraping may be needed to test for fungus.



- Tinea pedis is normally treated with topical antifungal creams.



- The imidazole antifungals - clotrimazole, econazole, ketoconazole, miconazole, and sulconazole - are all effective.



- Terbinafine cream is also effective but is more expensive.



- Application should be in a 4-6cm radius around the affected area as soon as feet begin to itch.



- Treatment should be continued until two weeks after clearance.



- Oral antifungal tablets can be prescribed if topical creams are found to be ineffective.



- Skin scrapings should be examined if systemic therapy is being considered.



- Antifungal dusting powders are not normally recommended, as they are of little therapeutic value and may cause skin irritation.



- Increased exposure to the spores at home or during recreational activities.



- Skin that produces less fatty acid, which is a natural antifungal agent.



- Wearing occlusive footwear.



- Wearing the same pair of socks or shoes for long periods.



- Hyperhidrosis (excessive sweating).



- Immune deficiency, for example due to medications such as azathioprine, or infection with HIV.



- Poor circulation resulting in cold feet.



Patients should be advised on the following preventative information:



- Wash feet and toes daily;



- Ensure feet are thoroughly dried after bathing;



- Keep skin between the toes dry;



- Use clean towels and do not share them in communal changing rooms;



- Wash towels frequently;



- Wear clean socks as fungi may have multiplied in unwashed socks;



- Wear cotton socks and leather footwear, which can ‘breathe’ and therefore reduce sweating;



- Do not go barefoot in communal changing rooms;



- As far as possible go barefoot at home to allow feet to breathe and dry out.



- Recurrence is common.



- Tinea pedis can spread to the hands due to scratching.



- Secondary infection.



Patient UK:



NHS Direct:

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