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