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Tinea Pedis
Aka: Tinea Pedis, Tinea Manum, Tinea Manuum, Tinea Manus, Athlete's Foot
- See Also
- Hand Dermatitis
- Foot Dermatitis
- Intertrigo
- Skin Infection
- Cutaneous Fungal Infection
- Definitions
- Tinea Manus (or Tinea Manuum)
- Dermatophyte infection of hand
- Tinea Pedis
- Dermatophyte infection of foot
- Risk Factors
- Heat
- Dampness
- Occlusive shoes
- Symptoms (most commonly affects foot)
- Pruritus
- Burning
- Signs
- General
- Interdigital maceration at web space
- Dry ScalingPlaques
- Fissuring
- Subtypes
- Vesiculobullous lesions
- Involves sole of foot
- Associated with Cellulitis and lymphangitis
- Moccasin (Sandal)
- Diffuse involvement of sole and dorsum
- Often presents as Scaling of sole
- Associated with Trichophyton rubrum infection
- May require systemic Antifungal for eradication
- Two foot and one hand disease
- Scaling of 1 hand and 2 feet
- Labs
- Potassium Hydroxide (KOH)
- Culture
- Staphylococcus aerobic coryneforms
- Gram Negative Bacteria
- Differential Diagnosis
- See Hand Dermatitis or Foot Dermatitis
- Dyshidrotic Eczema
- Contact Dermatitis
- Atopic Dermatitis
- Reiter's Syndrome
- Psoriasis
- Pustular Psoriasis
- Candidiasis
- Intertrigo
- Erythrasma
- Local Bacterial Infection (Cellulitis)
- Local callus formation
- Juvenile plantar dermatosis
- Shiny taut skin of the great toe, ball of the foot and heel
- Spares the web spaces
- Management
- Emphasize Foot care
- Avoid occlusive footwear
- Change to dry socks 2-3 times daily
- Dry between toes twice daily
- Change or alternate shoes
- Control Hyperhidrosis
- Drysol (20% aluminum hydroxide) applied bid
- Lazer Formalyde Solution (10% formaldehyde) applied
- Place lamb's wool piece between toes
- Lac-Hydrin cream (for Tinea Manum)
- Topical Antifungal (twice daily for 3-4 weeks)
- Technique
- Apply to normal skin 2 cm beyond affected area
- Continue for 7 days after symptom resolution
- First line: Imidazoles (e.g. Clotrimazole, OTC)
- Second line: Ciclopirox (Loprox) lotion or cream
- Refractory cases: Naftin, Lamisil, Mentax
- Systemic Antifungals
- Indicated in severe or refractory cases (not usually needed)
- Agents (dosing listed for adults)
- Terbinafine 250 mg orally once daily for 14 days or
- Fluconazole 150 mg orally once weekly for 3 weeks
- Treat Bacterial superinfection with antibiotics
- See Complications below
- Non-effective methods
- Avoid daily prophylaxis (not cost effective)
- Avoid Tea tree oil (equivalent to Placebo for cure)
- Complications
- ID Reaction
- Secondary Bacterial Cellulitis
- See Tinea Pedis Superinfection
- References
- Andrews (2008) Am Fam Physician 77(10): 1415-20 [PubMed]
- Schwartz (2004) Lancet 364(9440):1173-82 [PubMed]
- Evans (1993) BMJ 307:645-7 [PubMed]
- Tong (1992) Australas J Dermatol 33:145-9 [PubMed]