There are millions of species of fungi on earth, but only a handful can infect humans.
In the lower leg and foot, fungal infections are frequently seen in people of all ages and gender, and about 70% of this population will develop an infection at some point in their lifetime.
In the toenails, this infection is termed “onychomycosis”, on the foot “tinea pedis” and on the body“tinea corporis”.
Why does tinea pedis occur?
It is caused by the presence of superficial pathogens that assimilate epidermal keratin and interact with the cellular immune system. The three most common microorganisms in order of frequency are Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum.
Men are affected more than women, which is closely related to their increased exposure to swimming pools, athletic shoes, and locker rooms. Most susceptible are immunocompromised and diabetic individuals.
What are the signs and symptoms?
The most common form of tinea pedis is interdigital. It typically affects the fourth/fifth or third/fourth interweb space between the toes. This condition is exacerbated by skin confinement in a warm and humid environment. The appearance can range from simple scaling of the skin with minimal itching, to macerated raw areas with infection spreading to the underside of the toes or the top of the foot with blistering and inflammation.
Moccasin type tinea pedis refers to an infection that spreads to the foot’s sole and sides. It may be asymptomatic or itchy. With time, it gradually expands. It typically manifests as a red rash with a distinct edge of scaling.
Inflammatory tinea pedis causes itching, burning, and discomfort. There may be blisters on the bottom of the foot. There may be pus and a secondary infection may develop.
The ulcerative form of tinea pedis is characterised by the presence of vesicles and pustules accompanied by erosion and ulceration. Secondary bacterial infection is common. This infection is more prevalent in the immunocompromised and diabetics.
What to do if you experience symptoms of tinea pedis?
The best course of action is to seek medical advice. Occasionally, it may be difficult to distinguish between Eczema and the presence of a fungal infection, as the two conditions may coexist. Eczema treatments will exacerbate tinea pedis. In this instance, it is preferable to identify and treat the tinea first.
How important is to treat tinea pedis?
In the case of interdigital tinea pedis, failure to treat the condition may lead to secondary infections such as bacterial cellulitis.
For instance, the use of corticosteroids in the presence of tinea pedis and eczema may result in hair follicle infection. This is more common in immunocompromised individuals and those who have used topical steroids on tinea by accident.
How to treat tinea pedis?
Tinea pedis commonly co-exist with onychomycosis and therefore treatment should be aimed at both disorders.
Interdigital tinea pedis can be effectively managed by topical agents. Generally, the longer the creams are used, the more effective the outcome but common treatment periods are between 1 and 4 weeks.
Moccasin, ulcerative, and inflammatory tinea pedis frequently require systemic agents for treatment.
To find out more about treating and preventing fungal infections download our guide: Itchy Feet What Do You Know About Athlete's Foot?
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