Dermatology Book

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Tinea Pedis

Aka: Tinea Pedis, Tinea Manum, Athlete's Foot
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  1. See Also
    1. Intertrigo
  2. Definitions
    1. Tinea Manum: Dermatophyte infection of hand
    2. Tinea Pedis: Dermatophyte infection of foot
  3. Predisposing factors
    1. Heat
    2. Dampness
    3. Occlusive shoes
  4. Symptoms (most commonly affects foot)
    1. Pruritus
    2. Burning
  5. 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
  6. Labs
    1. Potassium Hydroxide (KOH)
    2. Culture
      1. Staphylococcus aerobic coryneforms
      2. Gram Negative Bacteria
  7. 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. Candidiasis
    8. Intertrigo
    9. Erythrasma
    10. Local Bacterial infection (Cellulitis)
    11. Local callus formation
  8. 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)
  9. Complications
    1. ID Reaction
    2. Secondary bacterial Cellulitis
      1. See Tinea Pedis Superinfection
  10. References
    1. Andrews (2008) Am Fam Physician 77(10): 1415-20
    2. Schwartz (2004) Lancet 364(9440):1173-82
    3. Evans (1993) BMJ 307:645-7
    4. Tong (1992) Australas J Dermatol 33:145-9

Tinea manus (C0153246)

Concepts Disease or Syndrome (T047)
ICD9 110.2
ICD10 B35.2
SnomedCT 48971001
Dutch tinea manuum, dermatofytose van de 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
Italian Dermatofitosi della mano, Tinea manuum
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, ﾋﾌｼｼﾞｮｳｷﾝｼｮｳﾃ, ﾃﾊｸｾﾝ, 手白癬
English tinea manuum (diagnosis), tinea manuum, Hand ringworm, tinea manus, 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
Korean 손 백선증
Hungarian Kéz dermatophytosisa, Tinea manum
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Tinea Pedis (C0040259)

Definition (MEDLINEPLUS)

Athlete's foot is a common infection caused by the tinea fungus. It is not serious. Symptoms include itching, burning and cracked, scaly skin between your toes. Tinea grows best in damp, dark and warm places, which is why it often develops between your toes. It can spread to your toenails, as well, making them thick and crumbly.

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

  • Wash your feet every day
  • Dry your feet well, especially between your toes
  • Wear clean socks
  • Don't walk barefoot in public areas
  • Wear flip-flops in locker room showers

Treatments include over-the-counter antifungal creams for most cases and prescription medicines for more serious infections.

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 186993002, 154399001, 6020002, 271427009
English Athlete Foot, Athlete's Foot, Athletes Foot, Tinea Pedis, TINEA PEDIS, tinea pedis, athlete's foot, tinea pedis (diagnosis), Dermatophytosis of foot (& tinea pedis) (disorder), Foot tinea, Foot ringworm, Tinea Pedis [Disease/Finding], pedis tinea, foot ringworm, athletes foots, athlete foot, 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 (& tinea pedis), Dermatophytosis of foot, Dermatophytosis of foot (disorder), 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 Dermatophytose des pieds, Teignes du pied, Trichophytie des pieds, 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, Tinha do pé, Frieira, 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), Athlete's foot, Tinea pedis, Dermatophytosis of foot, Dermatophytosis of foot (& tinea pedis), 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, Tina del Pie
Japanese 足の皮膚糸状菌症, ｿｸﾌﾞﾊｸｾﾝ, ｱｼﾉﾋﾌｼｼﾞｮｳｷﾝｼｮｳ, 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
Russian DERMATOFITIIA STOPY, STOPY MIKOZY, STOPA LEGKOATLETA, DERMATOMIKOZ STOPY, MIKOZY STOPY, EPIDERMOFITIIA STOP, ДЕРМАТОМИКОЗ СТОПЫ, ДЕРМАТОФИТИЯ СТОПЫ, МИКОЗЫ СТОПЫ, СТОПА ЛЕГКОАТЛЕТА, СТОПЫ МИКОЗЫ, ЭПИДЕРМОФИТИЯ СТОП
Korean 발 백선증
Polish Grzybica stóp, Grzybica stóp międzypalcowa
Hungarian Láb bőrgombája, Atléta-láb, Tinea pedis, Láb dermatophytosisa, Láb trichophytosis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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