II. Definitions

  1. Tinea Manus (or Tinea Manuum)
    1. Dermatophyte infection of hand
  2. Tinea Pedis
    1. Dermatophyte infection of foot

III. Risk Factors

  1. Heat
  2. Dampness
  3. Occlusive shoes

IV. Symptoms (most commonly affects foot)

  1. Pruritus
  2. Burning

V. Signs

  1. General
    1. Interdigital maceration at web space
    2. Dry ScalingPlaques
    3. Fissuring
  2. Subtypes
    1. Vesiculobullous lesions
      1. Involves sole of foot
      2. Associated with Cellulitis and lymphangitis
    2. Moccasin (Sandal)
      1. Diffuse involvement of sole and dorsum
      2. Often presents as Scaling of sole
      3. Associated with Trichophyton rubrum infection
      4. May require systemic Antifungal for eradication
    3. Two foot and one hand disease
      1. Scaling of 1 hand and 2 feet

VI. Labs

VII. Differential Diagnosis

  1. See Hand Dermatitis or Foot Dermatitis
  2. Dyshidrotic Eczema
  3. Contact Dermatitis
  4. Atopic Dermatitis
  5. Reiter's Syndrome
  6. Psoriasis
  7. Pustular Psoriasis
  8. Candidiasis
  9. Intertrigo
  10. Erythrasma
  11. Local Bacterial Infection (Cellulitis)
  12. Local callus formation
  13. Juvenile plantar dermatosis
    1. Shiny taut skin of the great toe, ball of the foot and heel
    2. Spares the web spaces

VIII. Management

  1. Emphasize Foot care
    1. Avoid occlusive footwear
    2. Change to dry socks 2-3 times daily
    3. Dry between toes twice daily
    4. Change or alternate shoes
  2. Control Hyperhidrosis
    1. Drysol (20% aluminum hydroxide) applied bid
    2. Lazer Formalyde Solution (10% formaldehyde) applied
    3. Place lamb's wool piece between toes
  3. Lac-Hydrin cream (for Tinea Manum)
  4. Topical Antifungal (twice daily for 3-4 weeks)
    1. Technique
      1. Apply to normal skin 2 cm beyond affected area
      2. Continue for 7 days after symptom resolution
    2. First line: Imidazoles (e.g. Clotrimazole, OTC)
    3. Second line: Ciclopirox (Loprox) lotion or cream
    4. Refractory cases: Naftin, Lamisil, Mentax
  5. Systemic Antifungals
    1. Indicated in severe or refractory cases (not usually needed)
    2. Agents (dosing listed for adults)
      1. Terbinafine 250 mg orally once daily for 14 days or
      2. Fluconazole 150 mg orally once weekly for 3 weeks
  6. Treat Bacterial superinfection with antibiotics
    1. See Complications below
  7. Non-effective methods
    1. Avoid daily prophylaxis (not cost effective)
    2. Avoid Tea tree oil (equivalent to Placebo for cure)

IX. Complications

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Related Studies

Ontology: Tinea Pedis (C0040259)

Definition (MEDLINEPLUS)

Athlete's foot is a common infection caused by a fungus. It most often affects the space between the toes. Symptoms include itching, burning, and cracked, scaly skin between your toes.

You can get athlete's foot from damp surfaces, such as showers, swimming pools, and locker room floors. To prevent it

  • Keep your feet clean, dry, and cool
  • Wear clean socks
  • Don't walk barefoot in public areas
  • Wear flip-flops in locker room showers
  • Keep your toenails clean and clipped short

Treatments include over-the-counter antifungal creams for most cases and prescription medicines for more serious infections. These usually clear up the infection, but it can come back.

Centers for Disease Control and Prevention

Definition (MSH) Dermatological pruritic lesion in the feet, caused by Trichophyton rubrum, T. mentagrophytes, or Epidermophyton floccosum.
Concepts Disease or Syndrome (T047)
MSH D014008
ICD9 110.4
ICD10 B35.3
SnomedCT 271427009, 186993002, 154399001, 6020002
English Athlete Foot, Athlete's Foot, Athletes Foot, Tinea Pedis, tinea pedis, tinea pedis (diagnosis), Foot tinea, Foot ringworm, Tinea Pedis [Disease/Finding], athlete's foot, pedis tinea, foot ringworm, athletes foots, athlete foot, Dermatophytosis of foot (& tinea pedis), Dermatophytosis of foot (disorder), Dermatophytosis of foot (& tinea pedis) (disorder), Athlete's foot, Tinea pedis, Epidermophytosis pedis, Ringworm of foot, TP - Tinea pedis, Tinea pedis (disorder), dermatophytosis; foot, foot; dermatophytosis, foot; ringworm, foot; tinea, pedis; tinea, ringworm; foot, tinea; foot, tinea; pedis, Dermatophytosis of foot, athletes foot
Italian Dermatofitosi del piede, Tinea pedis, Piede d'atleta, Tigna del piede
Dutch voettinea, ringworm van de voet, atleetvoet, dermatofytose van de voet, dermatofytose; voet, pedis; tinea, ringworm; voet, tinea; pedis, tinea; voet, voet; dermatofytose, voet; ringworm, voet; tinea, tinea pedis, Athlete's foot, Tinea pedis, Voetschimmel, Zwemmerseczeem
French Teignes du pied, Dermatophytose du pied, Teigne du pied, Dermatomycose du pied, Dermatophytose plantaire, Pied d'athlète, Intertrigo interdigital dermatophytique, Tinea pedis, Épidermophytie plantaire
German Ringwurm des Fusses, Dermatophytose des Fusses, Fusspilz, Tinea pedis, Fußpilz
Portuguese Pé de atleta, Dermatofitose do pé, Tinha dos pés, Frieira, Tinha do pé, Pé de Atleta, Tinha dos Pés
Spanish Pie de atleta, Tiña de los pies, Dermatofitosis de pie, Tiña de pie, dermatofitosis del pie, dermatofitosis del pie (trastorno), dermatomicosis de los pies, epidermofitosis del pie, pie de atleta, tiña de los pies (trastorno), tiña de los pies, tiña pedia, Tiña del pie, Pie de Atleta, Tiña del Pie
Japanese 足の皮膚糸状菌症, ソクブハクセン, アシノヒフシジョウキンショウ, 白癬-足部, 汗疱状白癬-足部, みずむし, 足白癬, 足部白癬, 水虫
Swedish Fotsvamp
Czech tinea pedis, Atletická noha, Tinea pedis, Plísňové onemocnění chodidla, Dermatofytóza chodidla
Finnish Jalkasilsa
Korean 발 백선증
Polish Grzybica stóp, Grzybica stóp międzypalcowa
Hungarian Láb bőrgombája, Atléta-láb, Tinea pedis, Láb dermatophytosisa, Láb trichophytosis
Norwegian Tinea pedis, Fotsopp

Ontology: Tinea manus (C0153246)

Concepts Disease or Syndrome (T047)
ICD9 110.2
ICD10 B35.2
SnomedCT 48971001
Dutch tinea manuum, dermatofytose van de hand, tinea van hand, dermatofytose; hand, hand; dermatofytose, hand; ringworm, manuum; tinea, ringworm; hand, tinea; manuum, Tinea manuum
French Tinea manuum, Dermatophytose de la main
German Dermatophytose der Hand, Tinea manuum, Handtinea
Italian Dermatofitosi della mano, Tinea manuum, Tigna della mano
Portuguese Dermatofitose da mão, Tinha da mão
Spanish Dermatofitosis de la mano, Tiña de la mano, dermatofitosis de las manos, tiña de las manos (trastorno), tiña de las manos
Japanese 皮膚糸状菌症、手, ヒフシジョウキンショウテ, テハクセン, 手白癬, シュハクセン
English tinea manuum (diagnosis), tinea manuum, Hand ringworm, tinea manus, Tinea of hand, Tinea manus, Dermatophytosis of hand, Tinea manuum, Tinea manus (disorder), dermatophytosis; hand, hand; dermatophytosis, hand; ringworm, manuum; tinea, ringworm; hand, tinea; manuum
Czech Tinea manuum, Dermatofytóza ruky, Plíseň ruky
Korean 손 백선증
Hungarian Kéz dermatophytosisa, Tinea manum