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Athlete’s Foot

Introduction

Athlete’s foot and toe fungus infection is called “tinea pedis” medically, and is usually caused by the fungus Trichophyton mentagrophytes.

It leads to a breakdown of the skin usually between the 3rd and 4th toes or the 4th and 5th toes.

Without treatment it will spread to the sole of the foot and often to the other foot. The skin is macerated and the borders are scaling (thanks to eggans.com for this image). There are blisters that break open later.The skin get super-infections with bacterial infections and can also infect the lymphatic vessels causing lymphangitis and lymphadenitis. The diagnosis is made clinically most of the time and also treated accordingly.

However, in cases where the physician is unsure of the diagnosis, a swab for culture can be done or a biopsy for histology to rule out other diagnoses.

Athlete's Foot

Athlete’s Foot

Treatment

Milder cases of athlete’s foot will respond to topical treatment with antifungal solution or cream such as ciclopirox (brand name: Loprox cream or lotion). However, when the infection has been there for some time and nails are getting involved in the infection, then a course of oral antifungal medication is needed such as itraconazole (brand name: Sporanox) 200 mg once daily for 1 month. Alternatively, terbinafine (brand name: Lamisil) 250 mg once per day for 2 to 4 weeks can be given. Liver and kidney toxicity has to be monitored.

 

References:

1.The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 265.

2.James Chin et al., Editors: Control of Communicable Diseases Manual, 17th edition, 2000, American Public Health Association

3.The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 112.

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 115.

5. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 113.

Last modified: August 27, 2014

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.