Tinea pedis

Athlete's foot, tinea pedum.

Fungal disease of the feet.

• Classification
  • Dyshidrotic type
  • Hyperkeratotic-rhagadiform type
  • Interdigital type
  • Moccasin type
  • Oligosymptomatic type

Incidence: 20% - 80%

• Pathogen
  • Trichophyton rubrum (approx. 80%)
  • Trichophyton mentagrophytes (approx. 10%)
  • Epidermophyton floccosum (approx. 4%)
  • Microsporum canis
  • Microsporum gypseum
• Predisposing factors
  • Foot deformities
  • Frequent wearing of tight shoes
  • Trauma
  • Hyperhidrosis
  • Disorders of blood circulation (acrocyanosis)
  • Diabetes mellitus
  • Peripheral neuropathy
  • Familial disposition
  • Male gender

• Infection by dermatophytes (see above). Transmission can occur from person to person or via the floor (indoor swimming pool)

• Dyshidrotic foot eczema: Palmar dyhidrotic vesicles localised especially in the arch of the foot
• Interdigital type: rhagades and dry scales appear interdigitally
• Moccasin type: Whitish, scaly plaques. Distribution resembles moccasins
• Hyperkeratotic-rhagadiform type: Pronounced hyperkeratoses are in the foreground. There is often painfulness when walking if rhagades are present.
• Oligosymptomatic type: Interdigital minimal redness and fine scaling. Hyperkeratosis may be seen on the edges of the feet

• Clinic
• Detection of pathogens (scales, pustule contents: native and culture; biopsy)

• Erysipelas
• Contact allergy
• Tinea unguium

• Clotrimazole spray 2-3x / week
• CAVE: Prolonged topical antifungal treatment may result in gram-negative forefoot infection (expulsion of gram-positive flora)

Chronic progression.

1. Aste N, Pau M, Aste N, Biggio P. Tinea pedis observed in Cagliari, Italy, between 1996 and 2000. Tinea pedis in Cagliari, Italien, zwischen 1996 und 2000. Mycoses 2003;46:38-41.
2. Lachapelle JM, De Doncker P, Tennstedt D, Cauwenbergh G, Janssen PA. Itraconazole compared with griseofulvin in the treatment of tinea corporis/cruris and tinea pedis/manus: an interpretation of the clinical results of all completed double-blind studies with respect to the pharmacokinetic profile. Dermatology 1992;184:45-50.
3. Lacroix C, Baspeyras M, de La Salmoniere P, et al. Tinea pedis in European marathon runners. Journal of the European Academy of Dermatology and Venereology 2002;16:139-42.
4. Lupa S, Seneczko F, Jeske J, Glowacka A, Ochecka-Szymanska A. Epidemiology of dermatomycoses of humans in Central Poland. Part III. Tinea pedis. Mycoses 1999;42:563-5.
5. Satchell AC, Saurajen A, Bell C, Barnetson RS. Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: A randomized, placebo-controlled, blinded study. Australas J Dermatol 2002;43:175-8.
6. Goldstein, A. (2016). Dermatophyte (tinea) infections. Uptodate.com. Retrieved 30 May 2016, from http://www.uptodate.com/contents/dermatophyte-tinea-infections?source=search_result&search=tinea+corporis&selectedTitle=1~51