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Risk factors Poor hygiene, occlusive footwear, prolonged moisture of skin, minor skin or nail injuries; tinea infections are contagious, and can be passed through direct contact, or contact with items such as shoes, stockings, and shower or pool surfaces
Agents Trichophyton rubrum, T mentagrophytes, Epidermophyton floccosum
Management Drying; if recalcitrant, haloprogin, tolnaftate; if refractory, griseofulvin
tinea pedisAthlete's foot, see there.
tin·e·a pe·dis(tin'ē-ă ped'is)
Synonym(s): athlete's foot.
tinea(tin'e-a ) [L. tinea, bookworm]
There are two types of findings. Superficial findings are marked by scaling, slight itching, reddish or grayish patches, and dry, brittle hair that is easily extracted with the hair shaft. The deep type is characterized by flat, reddish, kerion-like tumors, the surface studded with dead or broken hairs or by gaping follicular orifices. Nodules may be broken down in the center, discharging pus through dilated follicular openings.
Griseofulvin, terbinafine, or ketoconazole is given orally for all types of true trichophyton infections. Local treatment alone is of little benefit in ringworm of the scalp, nails, and in most cases the feet. Topical preparations containing fungicidal agents are useful in the treatment of tinea cruris and tinea pedis.
Personal hygiene is important in controlling these two common diseases. The use of antiseptic foot baths to control tinea pedis does not prevent spread of the infection from one person to another. Persons affected should not let others use their personal items such as clothes, towels, and sports equipment.
Tinea of the scalp, tinea capitis, is particularly resistant if due to Microsporum audouinii. It should not be treated topically. Systemic griseofulvin is quite effective.
tinea barbaeBarber's itch.
tinea pedisAthlete's foot.
tinea profundaMajocchi's disease.
tinea sycosisBarber's itch (2).
tinea tonsuransTinea capitis.
tinea pedisInvolvement of the skin between the toes and, sometimes, the remainder of the skin of the foot, with the fungus infection TINEA.
tinea pedis; athlete's foot tinea characterized by intense itching, vesiculation, fissures, scaling, maceration and eroded areas, especially interdigitally, at medial longitudinal arch and plantar skin, and heel perimeter; due to Trichophyton rubrum, T. mentagrophytes var . interdigitale Epidermophyton floccosum infection (see Table 1)
|Antimycotic agent (for the treatment of dermatophytosis)|
|Skin||Topical 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 )
|Nail||Topical 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)
|Skin||Topical antimycotic creams (1% clotrimazole; 1% econazole; 2% miconazole)|
Topical nystatin (100 000 units ± 1% tolnaftate)
Antipityriasis versicolor agent (for the treatment of pityriasis versicolor)
|Skin||Topical 2% ketoconazole|
Topical 2.5% selenium sulphide
Topical antimycotic agents (1% clotrimazole; 1% econazole; 2% miconazole; 1% sulconazole; 1% terbinafine)
tinea pedis (ti·nēˑ· peˑ·dis),
Patient discussion about tinea pedis
Q. what else besides athletes foot can cause painful itchy burn tops of toes if the toes are bumped they throb and it hurts to flex toes, small red spots on toes