Tinea pedis
Tinea Pedis
Fungal (dermatophyte) infection of the feet.
Sometimes also known as athlete’s feet due to
common occurrence among athlete
Common organisms;
Trichophyton, Microsporum, Epidermophyton
Risk factors
● Occlusive footwear (for example, heavy
industrial boots)
4 types of Tinea Pedis:
1. Interdigital type
- Dry scaling type
- Moist (macerated
type)
2. Moccasin type
- Chronic/ hyperkeratotic
type
3. Inflammatory or bullous
(vesicular) type
- Blister formation
4. Ulcerative type
- Extension of interdigital
type into dermis due to
maceration
Prevention of reccurence:
● Dry feet and toes meticulously after
bathing
● Use desiccating foot powder once or twice
daily
● Avoid wearing occlusive footwear for long
periods
● Thoroughly dry shoes and boots
● Clean the shower and bathroom floors
using a product containing bleach
● Treat shoes with antifungal powder.
Pharmacological treatment:
First Line :
Miconazole 2% LA BD for up to 4-8/52
(including 2/52 after lesion cleared)
Resistant (first line):
Itraconazole 200 mg PO OD (2-4 /52)
/ Terbinafine 250mg PO OD (2-4 /52
/Griseofulvin 500mg POBD (6-12 /52)
 Tinea Corporis
Tinea Pedis
Fungal (dermatophyte) infection of the skin on body.
Risk factors:
Scaly, sharply marginated annular, concentric rings or
arcuate patch with central clearing
1. Individual
Common organisms;
Trichophyton (T. Interdigitale, T. consurans),
Microsporum (M. canis), Epidermophyton
1.
Complications
● Tinea corporis is contagious, spreading
elsewhere on the skin and to others.
● Immunosuppessed patients, such as those with
HIV/AIDS, can present with disseminated
infection.
● Chronic dermatophytosis is T. rubrum infection
of at least four body sites following a prolonged
fluctuating course and recurrence despite
treatment.
● Dermatophytide reactions are an allergic rash
Non-pharmacological treatment:
Skin should be kept clean and dried thoroughly. Loose-fitting light
clothing is recommended in hot humid climates. Avoid close contact
with infected individuals and the sharing of fomites. Examination of
household members and pets for the source of infection and
appropriate treatment reduces the risk of re-infection.
● Previous or concurrent tinea infection
● Diabetes mellitus Pharmacological treatment:
● Immunodeficiency
● Hyperhidrosis (excessive sweating) First Line :
●
Miconazole 2% / Clotrimazole 1%/
Xerosis (dry scaly skin)
ketoconazole/terbinafine
● Ichthyosis (persistent widespread thick dry, fish-
• LA BD for up to 4-8/52 (including 2/52 after lesion
scale like skin) cleared)
Environmental
● Household crowding Resistant:
● Infection of household members Itraconazole 200 mg PO OD (2/52)
● Keeping house pets / Terbinafine 250mg PO OD (2/52
● Wearing occlusive clothing /Griseofulvin 500mg PO BD or OD (4-6 /52)
● Recreational activities involving close contact
with others including shared change rooms
 Tinea Unguium
Tinea Unguium 1. Toenails more infected than fingernails Non- Pharmacological treatment:

Fungal (dermatophyte) infection of the feet.
Sometimes also known as athlete’s feet
due to common occurrence among athlete
Common organisms;
Trichophyton, Microsporum,
Epidermophyton
2. First and fifth toenails most commonly
infected, probably de to traumatic damage
by ill fitting footwear
3. White or yellow irregular lesion appears
first at free end of nail and spread slowly to
cause entire nail to become thickened,
opaque and yellow in color, and it may
crumble
Removal of the nail is rarely necessary but
may be considered if there is total nail
destruction. Surgical removal is unpleasant
and painful. Chemical evulsion can be
performed by applying urea paste under
occlusion and repeating every few days as
necessary. It may take many months for the
nail to regrow
Pharmacological treatment:

First Line :
Amorolfine 5% Nail lacquer weekly
application
(fingernail 6/12, toenails 12/12)
Or
Pulse Itraconazole 200mg PO BD form
1/52 per month
(fingernails 2/12, toenails 3/12)
Or
Terbinafine 250mgPO OD
(fingernail 6/52, toenails 12/52)