fungal foot infections

fungal foot infections

dry, irritant and vesicular eruptions, intertriginous maceration, chronic hyperkeratotic or eczematous reactions in areas of skin (and nails) due to infection by anthropophilic (human- to-human contagion), zoophilic (animal-to-human) or geophilic (earth-to-human) fungi; superficial infections are caused by dermatophytic (Trichophyton, Epidermophyton and Microsporon species) or candidal (Candida albicans) species, which secrete lytic enzymes into keratinized tissues, allowing hyphae to penetrate between keratinized skin cells; natural resistance to fungal infections is dependent on skin surface quality and local secretions (sweat and sebum) in relation to genetic, age, nutritional and hormonal factors; dysfunctional skin (e.g. dyshidrotic, atrophic, broken skin), immunosuppression, long-term antibiosis or steroids and diabetes all render the subject more prone to fungal and candidal infections; Table 1; see dermatophytosis; onychomycosis; Table 2
Table 1: Characteristics of fungal infections in the foot
PresentationCharacteristics
Interdigital skin infection (intertrigo)Macerated tissue and webspace fissures Or dry, flaking tissue and webspace fissures ± pruritus
Moccasin skin infectionDry, flaking skin affecting most of plantar surface, border skin and extending on to the dorsum from the interdigital spaces, ± pruritus
Hyperkeratotic skin infectionIncreased formation of plantar keratin, with fissuring (especially around heels)
Vesicular skin infectionIntensely itchy, vesicular eruptions along plantar web line and medial longitudinal arch
Superficial nail infectionFormation of white, powdery patches or plaques on dorsal surface of one or many nails (also known as white superficial onychomycosis)
Tobacco nailFormation of white/yellow/brown streak extending from distal to proximal area of intermediate nail plate, with local plate dystrophy
Total onychomycosisContamination of the entire nail plate by fungal infection, leading to plate hypertrophy, dystrophy, discoloration and onycholysis
Table 2: Treatment of fungal infections of skin and nails
Infection siteAgent
Antimycotic agent (for the treatment of dermatophytosis)
SkinTopical allylamine (e.g. 1% terbinafine cream for 7 days)
Topical imidazoles (e.g. 2% miconazole or 1% clotrimazole for 28 days)
Topical 0.25% amorolfine
Topical 1% econazole
Topical griseofulvin spray (400 μg puff daily for 14 days)
Topical 1% sulconazole
Topical tea tree (manuka) oil
Topical undecenoate (20% zinc undecenoate + 5% undecenoic acid)
Topical Whitfield's ointment (6% benzoic acid + 3% salicylic acid)
Other topicals include: weak iodine solution 2.5%; potassium permanganate paint 1%; salicylate acid cream or alcoholic solution 3-5%; benzoic acid (Whitfield's) ointment; sodium polymetaphosphate dusting powder
Systemic terbinafine (250 mg daily for 2 weeks)
Systemic itraconazole (100 mg daily for 15 days)
Systemic griseofulvin (500 mg daily )
NailTopical amorolfine 0.25% lacquer as an adjunct to systemic treatment
Topical borotannic acid complex acid; Phytex paint (1.46% salicylic acid + 4.89% tannic acid + 3.12% boric acid)
Topical 28% tioconazole lacquer
Topical undecenoate lacquer; Monphytol paint (5% methyl undecenoate + 0.7% propyl undecenoate + 3% salicylic acid + 25% methyl salicylate + 5% propyl salicylate + 3% chlorambucil)
Other topicals: strong iodine 10% solution
Systemic terbinafine (250 mg daily for 12-16 weeks)
Systemic itraconazole (400 mg for 1 week in a month, repeated overall 3 or 4 times)
Anticandidal agent (for the treatment of candidiasis)
SkinTopical antimycotic creams (1% clotrimazole; 1% econazole; 2% miconazole)
Topical nystatin (100 000 units ± 1% tolnaftate)
Antipityriasis versicolor agent (for the treatment of pityriasis versicolor)
SkinTopical 2% ketoconazole
Topical 2.5% selenium sulphide
Topical antimycotic agents (1% clotrimazole; 1% econazole; 2% miconazole; 1% sulconazole; 1% terbinafine)
Systemic fluconazole/itraconazole/ketoconazole/miconazole/voriconazole
References in periodicals archive ?
VANCOUVER -- Fungal foot infections in diabetic patients are often ignored and are far more than a cosmetic problem.
A systematic review of the published literature on treatment of diabetic fungal foot infections concluded that there is good evidence that oral terbinafine is as safe and effective as itraconazole for treating onycho m ycosis.
For yeast-type fungal foot infections, milder cases can be cleared up by thorough daily cleaning with surgical spirit.
Fungal foot infections in patients with diabetes mellitus--results of two independent investigations.
Common fungal foot infections in diabetes patients can trigger limb-threatening complications by raising the risk of secondary bacterial infections, foot ulcers, cellulitis, gangrene and paronychia, if left untreated.
A clinomycological study of fungal foot infections among Algerian military personnel.
dimidiatum fungal foot infections are clinically indistinguishable from dermatophytes and may lead to treatment failure.
The survey claimed the 'make do and mend' approach was seeing people use up old drugs, endure cracked teeth, soak their feet in mouthwash to sooth fungal foot infections or mend broken glasses with tape.
NEW YORK -- Fungal foot infections cause pain and embarrassment to millions of sufferers, and providing relief for such infections also provides an opportunity for strengthened sales in the category.
One major implication of this finding from a new case-control study is that it is critical to treat and eliminate any fungal foot infections present in patients with a history of bacterial cellulitis, said Dr.
BAD FOR THEM: High heels, tight shoes and fungal foot infections which affect at least 15 per cent of the population.
9 BEAT INFECTIONS ATHLETE'S foot is one of the most common fungal foot infections and is mainly spread in communal showers, so wear flip flops at the pool or gym and always dry thoroughly between your toes, as the fungus loves damp conditions.