What is Tinea and what causes it?
Tinea pedis, or Athlete’s Foot as it’s more commonly called, is a common skin infection of the feet. It occurs as a result of a dermatophyte fungal infection affecting the outermost layer of the skin. Most often infection occurs through direct contact with infected people, objects or locations (e.g. shoes, socks, carpets, public showers etc.). However, animals or soil can also be a source of infection (Garber 2001). In most cases tinea pedis is not a serious health concern, however, it can often have a significant impact on one’s daily life.
Who does Tinea affect?
It is reported that approximately 15% of the world’s population is affected by tinea pedis, making it the most prevalent fungal infection in the developed world (Bell-Syer et al. 2012; Garber 2011). The prevalence of tinea pedis increase with age. It is most common amongst those aged between 31-60 years old, and is relatively rare in children. Men are also at a higher risk than women. Those who are exposed to trauma, excessive sweating, occlusive footwear, and communal areas are also at a greater risk in developing tinea pedis (Ilkit & Durdu 2014).
What are the symptoms of Tinea?
There are three common forms of tinea pedis, these are interdigital, plantar, and vesicular tinea pedis. Each of these forms have differing clinical presentations and symptoms.
Interdigital tinea pedis – typically presents as a macerated, itchy, red, and scaly rash. It is most often found in between the toes (Bell-Syer et al. 2012).
Plantar type tinea pedis – Typically presents as a very fine and powdery scaling of the skin. This scaling of the skin most often covers the heel, sides, and sole of the foot. It is often described as a moccasin effect as there is usually a distinct redness around the ‘rim’ of the foot (Bell-Syer et al. 2012).
Vesicular type tinea pedis – Has the distinct appearance of vesicle, pustules, or blisters. It can often look similar in appearance to dermatitis (Bell-Syer et al. 2012).
How do we treat Tinea?
Tinea pedis is easily treated with either topical or oral antifungal medications. There are many different types of topical antifungal agents and it has been shown there is no difference in effect, safety, or tolerability among these various classes (Rotta et al. 2012). With topical treatment, creams are typically used anywhere between 1-6 weeks depending on the concentration and type of content (Ilkit & Durdu 2014).
Often patients cease using medications once their symptoms have appeared to have resolved. However, this often leads to recurrence as, although, the symptoms have resolved, the infectious fungal spores remain resulting in reinfection. It is therefore vitally important to follow the medication course accurately to ensure complete resolution.
References
Bell-Syer SEM, Khan SM, Torgerson DJ 2012, Oral treatments for fungal infections of the skin of the foot, Cochrane Database of Systematic Reviews, Art. No.: CD003584. DOI: 10.1002/14651858.CD003584.pub2.
Garber, G 2001, ‘An Overview of Fungal Infections’, Drugs, vol. 61, no. 1, pp. 1-12.
Ilkit, M & Durdu, M 2014, ‘Tinea pedis: The etiology and global epidemiology of a common fungal infection’, Critical Reviews in Microbiology, vol. 41, no. 3, pp. 1-15.
Rotta, I, Ziegelmann, PK, Otuki, MF, Riveros, BS, Bernardo, NL & Correr CJ 2013, ‘Efficacy of topical antifungals in the treatment of dermatophytosis: a mixed-treatment comparison meta-analysis involving 14 treatments’, JAMA Dermatology, vol. 149, no. 3, pp. 341-349.