Tinea pedis

Tinea pedis (athlete's foot) is the most common dermatophyte infection, usually found in adolescents and young adults (1). Characteristically, it is found in the toe webs, especially the fourth, where the tissue tends to be macerated, white and cracked (1).

Tinea pedis may present as:

• Interdigital type - most common type, characterized by white, cracked, or macerated areas between the toes
• Moccasin type –presents with scaly and thickened skin with hyperkeratosis and erythema which involves the entire sole and side of the foot
• Vesicobullous type – presents with eruptions of vesicles, pustules, and sometimes bullae, mainly on the soles of the feet (2)

Pain and Pruritus may occur. Dry fissuring of the infected area may provide a site for bacterial entry and a secondary cellulitis (2).

Infection on the sole may be more difficult to diagnose. There may be vesicles acutely, and scaling and cracking when chronic. Differentiation from psoriasis or eczema may be difficult.

Exposure to a moist environment, trauma, occlusive footwear, and regular user of public showers and pools acts as predisposing factors for developing the disease (3).

Most commonly, infection is due to Trichopyton rubrum, T. mentagrophytes and Epidermophyton floccosum (3).

Reference:

• (1) Weinstein A, Berman B. Topical treatment of superficial tinea infections. AFP 2002;65(10)
• (2) Hainer BL. Dermatophyte infections. AFP 2003;67(1)
• (3) Al Hasan M wt al. Dermatology for practicing allergist: tinea pedis and its complications. Clinical and Molecular Allergy 2004;2(5)