DISORDERS AND MANAGEMENT - TINEA PEDIS - ATHLETES FOOT

What age group is Tinea pedis normally found in

Adults

What form of fungicidal treatments are dispensed

Creams, ointments, lotions, aerosol sprays, powders A wide variety of anti fungal preparations are available without prescription The choice of base depends on the state of the skin

What type of infection is Tinea pedis

Dermatophyte infection [a pathogenic fungus that grows on the skin, hair, mucous membrane, nails etc.

How would you treat Tinea Pedis

Identify the probable source and give advice to avoid source Foot hygiene and type of footwear Be meticulous when drying feet Do not share towels or footwear

What are the most inter-digitally common sites

3rd and 4th - medial and lateral borders - Dorsey of the toes

What time of the year is Tinea Pedis usually worse

In winter when occlusive footwear is worn more often

What is penetration of keratinised cells by producing enzymes that can degrade or split the keratin due to

An Infection of the host by the fungi

Name some severe clinical features of Tinea Pedis

Associated inflammation Extremely itchy Macerated raw areas Bleeding Blistering The possibility of superimposed bacterial infection (gram negative) If associated with hyperkeratosis [commonly found on heel] appears dry, areas dry with fissuring and surrounded inflammation

What is Tinea Pedis

Athletes foot

What is the prognosis

Good prognosis Good advice given re hygiene, footwear etc. Advice on getting treatment if needed

What other skin condition may Tinea Pedis be associated with

Hyperkeratosis (very dry skin) a thickening of the s. Corneum - an abnormal quantity of keratin

Name some mild clinical features of Tinea Pedis

May be confused with Erythrasma Symptoms are negligible Simple scaling of the skin Minimal itching

Name some treatments for Tinea Pedis

Mycota, Tineafax - effective against the common pathogens Impedes fungal growth in Tinea Pedis Cure rate 50% Tolnaftate - Effective in mycosis caused by a wide range of Trichophyton species, E. floccosum and several of the Microsporum species May cause skin irritation Cure rate 80% The Imidazoles - These have a broad spectrum anti fungal activity and are effective topically against nearly all the fungi of clinical interest podiatry Terminating [Lamisil] is the most popular agent Also available in oral preparation Tea Tree oil More commonly used in podiatry

Where are most dermatophyte infections involving the skin confined to and where do they rarely extend beyond

Stratum - S. Corneum and rarely extend beyond the S. Granulosum

Where are you most likely to encounter transmission of infection

Swimming pools, communal changing rooms, shower rooms etc.

What part of the foot does it mostly effect

The soles of the feet and the interdigital spaces

Using enzymes called keratinases, where does dermatophyte fungi invade

The superficial keratin of the skin

What are the most common causative organisms in terms of frequency

Trichophyton rubrum Trichophyton interdigital with Epidermophyton flocassum