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) [4].

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 [10].

• Foot Disease

  Infectious Infection Mycoses Skin Diseases Foot Dermatoses Foot Diseases Pruritus Skin Manifestations Signs and Symptoms [clinicaltrials.gov]

• Foot Pain

  Insoles, Orthotics and Arch Supports Ready-made insoles are marketed for relief of heel pain, foot pain and back pain. [web.archive.org]

• Eczema

  Potassium permanganate baths are effective for the treatment of infected eczema when there are blisters, pus and/or oozing. Twice daily baths for two days help to dry out the weeping sores and soothe the eczema. [dermnetnz.org]

  Some cases do not respond to treatment for tinea or eczema. METHODS: Patients with foot intertrigo with a poor response to antifungal or antiinflammatory treatment from 2004 to 2009 were included in this study. [ncbi.nlm.nih.gov]

  Some of the other clinical entities to consider include: Dyshidrotic Eczema also known as: pompholyx, vesicular palmoplantar eczema. Original thoughts were that this was a disorder of sweat glands. [drpribut.com]

• Pruritus

  Improvements in patient quality of life (pruritus) and patient preference were measured using the pruritus visual analog scale (VAS), Skindex-16, and patient preference questionnaires. [ncbi.nlm.nih.gov]

• Skin Disease

  BACKGROUND: Tinea pedis is a common skin disease affecting most of the population during their lifetime. Topical and systemic treatments give only temporary relief. [ncbi.nlm.nih.gov]

• Foot Rash

  […] treat athlete's foot with antifungal cream Symptoms include: Itching Foot rash There are different kinds of athlete's foot rash: Cracked, red, peeling skin between your toes Thickened, scaly skin on the soles of your feet Rarely, fluid-filled blisters [msdmanuals.com]

  She is prescribed an antifungal cream for treatment of both her hand and foot rash. [step2.medbullets.com]

  Rather, it's an allergic response to the original foot rash. An id reaction will clear on its own once the original athlete's foot resolves. [verywell.com]

• Plantar Hyperkeratosis

  Infection of the interdigital spaces and plantar surface is characterized by inflammatory and noninflammatory lesions. The major clinical forms of tinea pedis are: 1) intertriginous; 2) plantar hyperkeratosis and 3) vesiculo-bullous infections2. [scielo.br]

  For tinea pedis plantar hyperkeratosis form was observed in 44 cases (62.8%) and plantar dyshidrosis in 26 cases (37.1%). [hindawi.com]

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.

• Trichophyton Rubrum

  […] interdigitale Tinea pedis due to Trichophyton rubrum Tinea pedis due to Trichophyton violaceum Clinical Information TINEA PEDIS-. dermatological pruritic lesion in the feet caused by trichophyton rubrum t. mentagrophytes or epidermophyton floccosum. [icdlist.com]

  We report here two cases of bullous tinea pedis, one due to Trichophyton rubrum in a 6-year-old child and the second due to T. interdigitale in a 10-year-old child. [ncbi.nlm.nih.gov]

  The Jock Itch or Tinea cruris in the groin area may also develop for it is also caused by the same fungus, Trichophyton rubrum. [symptoma.com]

  Explore these free sample topics: -- The first section of this topic is shown below -- PATHOGENS Trichophyton rubrum Trichophyton interdigitale Trichophyton mentagrophytes Rare: Epidermophyton floccosum Candida spp. [hopkinsguides.com]

• Trichophyton Mentagrophytes

  Until now an identification of T. mentagrophytes var. nodulare based on DNA-patterns has not been published. Trichophyton mentagrophytes var. nodulare is supposed to be an anthropophilic dermatophyte causing ordinary tinea and onychomycosis. [ncbi.nlm.nih.gov]

  Explore these free sample topics: -- The first section of this topic is shown below -- PATHOGENS Trichophyton rubrum Trichophyton interdigitale Trichophyton mentagrophytes Rare: Epidermophyton floccosum Candida spp. [hopkinsguides.com]

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 [3].

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 [6].

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 [8]. It is to be expected that cases of Tinea pedis may recur regularly even after treatment.

Complications

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 [5].

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 [7].

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 [2]. 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 [9].

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 [1].

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.

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2. Gentles JC. The isolation of dermatophytes from the floors of communal bathing places. J Clin Pathol. Nov 1956;9(4):374-7
3. Weinberg JM, Koestenblatt EK. Treatment of interdigital tinea pedis: once-daily therapy with sertaconazole nitrate. J Drugs Dermatol. Oct 1 2011;10(10):1135-40.
4. Pellizzari C. Recherche sur Trichophyton tonsurans. G Ital Mal Veneree. 1888;29:8.
5. Gupta AK, Cvetkovic D, Abramovits W, Vincent KD. LUZU (luliconazole) 1% cream. Skinmed. Mar-Apr 2014;12(2):90-3
6. Matricciani L, Talbot K, Jones S. Safety and efficacy of tinea pedis and onychomycosis treatment in people with diabetes: a systematic review. J Foot Ankle Res. Dec 4 2011;4:26.
7. Gul U, Cakmak SK, Ozel S, Bingol P, Kaya K. Skin disorders in patients with hemiplegia and papaplegia.J Rehabil Med. Jul 2009;41(8):681-3
8. Frykberg RG, Zgonis T, Armstrong DG, et al. American College of Foot and Ankle Surgeons. Diabetic foot disorders: a clinical practice guideline. J Foot Ankle Surg. Sep-Oct 2006;45(5):S2-66.
9. Elewski BE. Tinea pedis and tinea manuum. In: Demis DJ. Clinical Dermatology. Vol 3. Philadelphia, Pa: Lippincott; 1999:Unit 17-9; 1-11
10. Freedberg IM, Eisen AZ, Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 5th ed. New York, NY: McGraw-Hill; 1999:2349-51