The Tinea pedis infection usually starts as reddish rash in the interdigital area of the foot with predilection to the fourth and fifth digits of the toes. The rash will start to scale and form fissuring of the skin forming linear wound which may be painful with pruritus (burning and itching sensation) .
Chronically, scaling may evolve to maceration of the local tissue exuding a foul smelling odor from the wound. At this point, secondary bacterial infections of the skin may set in. Variants presenting with pustule and vesicles may also present during the erythematous stage of the disease. Toe nails may discolor and deform in the affected digit where it is observably brittle to manipulate.
Although the term “Pedis” refers exclusively to the foot, the fungus causing Tinea pedis like Trichophyton rubrum may affect other parts of the body like the fingers, fingernails, palm of the hands and groins. The clinical presentation in the other parts of the body is very similar to the toe afflictions .
A detailed medical history of the clinical course of the disease may easily clinch the suspicion of tinea pedis in patients. The characteristic lesion seen by the physician may herald the Trichophyton’s presence in the affected area of the foot. In this classical scenario, the physician may opt to proceed in treating the disease while waiting for confirmatory tests.
In cases where laboratory confirmation is required, skin scrapings may be taken and drenched in KOH (Potassium Hydroxide) and examined in under the microscope where the fungal mycelia and spores are seen under the magnifications.
The exposure of the foot to a black light or Wood’s light may reveal fluorescent greenish hue which is characteristic of erythrasma bacterial infection which usually coexist with Trichophyton infection. When these tests become inconclusive, samples from the lesions may be taken for culture to identify the pathogen.
Tinea Pedis in its mild form may only require topical antifungal treatment in the form of creams, ointment, gels and spray which may take a month of continuous treatment applied twice daily .
Severe cases may need oral or parenteral antifungals to augment the topical agents. Toe nails removal may be required if observable secondary bacterial infection is widespread and toe nail is no longer salvageable .
With adequate antifungal therapy and foot care, Tinea pedis carries a very good prognosis. Untreated cases of Trichophyton infection may eliminate the helpful resident bacteria of the skin and cause an overgrowth of harmful bacteria that may cause a more dangerous secondary infection like cellulitis . It is to be expected that cases of Tinea pedis may recur regularly even after treatment.
Tinea pedis is fairly contagious thus other parts of the body may be affected. Scratching the itch in the toes may infect the fingernails in the same way and while it is scratched to other body parts, fungal spores may be deposited in the stratum corneum in other areas resulting to a new infection .
The Jock Itch or Tinea cruris in the groin area may also develop for it is also caused by the same fungus, Trichophyton rubrum. The imbalance of bacterial and fungal flora may cause other infections to thrive in the affected organ like cellulitis, pyoderma and necrosis making it more difficult to treat .
Tinea pedis is caused by a fungus known as Trichophyton which are dermatophytes that inhabit the stratum corneum – the dead layer of the skin and nails.
It is a normal resident flora of the skin which are opportunistic in nature, waiting for the right suitable conditions like warm and moist skin like the skin in between the toes before it blooms into a fungal infection . The most common species for Tinea pedis is Trichophyton rubra in more than 70% of the cases and less commonly by Trichophyton tonsurans, Trichophyton mantagrophytes, and Microsporum canis.
The term Athlete’s foot was coined because the disorder is more prevalent in this type of group class. It is contagious with infected fomites like towels and tubs while it can also be acquired from communal baths, steam rooms, gym, swimming pools and sports clubs. These are the kind of places athletes would frequent .
There is a slight preponderance of the disease in males than in females. Footwear use greatly influence the spread of the infection were it favors closed and tight footwear because of high humidity and warmth, while walking on sandals or barefoot may allow the outer layer of the skin to dry up fast and inhibit the fungal growth. Pet handlers may acquire the affliction from infected canines (M. canis) in less than 10% of cases, dogs harbor the fungus in their furs increasing prevalence to humans with increased human to animal interactions.
The Trichophyton infection in Tinea pedis or Athlete’s foot is basically an opportunistic affliction caused by the imbalance of the normal flora. The warm and humid environment is the intertriginous (in between toes) areas of the skin triggers the overgrowth of the Trichophyton overwhelming the other limiting the growth of other organism.
This mycosis that thrives in the dead layer of the skin may also affect the toenails. The crusting formation in the keratinized nail bed causes it to discolor or and become brittle. The incrusting and the epidermal invasion of the fungus beyond the stratum corneum layer causes irritation and itching to the skin. The typical reddish discoloration of inflammation in skin is mostly observable in Trichophyton rubrum infection.
It is imperative to keep our feet dry all the time to prevent fungal growth. Footwear should not be too tight and must be ventilated to avert humidity build up. Foot powder with antifungal properties may benefit the foot. Wearing of socks may prevent over sweating of the foot especially in long runs or walks. Shoe sharing is oftentimes discourage to keep the spread of infection.
Tinea pedis or more commonly known as “Athlete’s foot” is scaly and itchy rash in the foot that usually begins in the toes. This is particularly common in athletes because it usually thrives in wet and sweaty foot enclosed in clothing like socks .
Tinea pedis is a recurring disease that is fungal in nature and is easily treated with topical antifungal ointments. This fungal species is closely related to other fungal infections like tinea cruris, tinea circinata and tinea flava.
People should always protect their foot especially in public baths or public swimming pools where transmission of the disease is frequently noted. When the early signs are noticed in the foot, medical attention must be sought to prevent the spread of the disease.
Those individuals with on-going infection should exert all efforts to avoid spreading the disease by prudently isolating infection by not sharing fomites and shoes to others.