Symptoms
Athlete’s foot (tinea pedis) usually develops between the toes and manifests as sometimes severe itching, burning, reddening of the skin, white softened, peeling and torn skin, skin blisters and dry skin. The symptoms also occur on the soles of the feet and are accompanied by hyperkeratosis. In the course, a difficult-to-treat nail fungus may additionally develop and the lesions may become bacterially superinfected. The following types are distinguished:
- Interdigital type: Toe interdigital spaces.
- Hyperkeratotic type (moccasin mycosis): dry scaling on the sole of the foot.
- Dyshidrotic type: inflammatory, with breaking open vesicles.
Causes
The cause lies in an infection with skin fungi, which multiply in the skin and feed on it. The dermatophyte is often responsible . The fungi can be transmitted directly, from skin to skin, or indirectly through surfaces, for example, in a swimming pool or sauna. The fungal spores are resistant and can survive for months. A humid and warm climate favors infection.
Diagnosis
Diagnosis is usually made under medical treatment on the basis of the clinical picture and with microscopic detection (KOH). Other skin diseases that cause similar symptoms, such as eczema, must be excluded. Culture is often not necessary.
Drug treatment
Athlete’s foot usually does not disappear on its own and should be treated consistently with medication. Antifungals, drugs against fungi, are available for treatment and are usually applied locally in the form of creams, ointments, as a spray or solution. Oral therapy is necessary only in severe cases. The most commonly used drug groups within antifungals include: Azole antifungals:
- Azole antifungals, such as econazole (Pevaryl), clotrimazole (Canesten), and miconazole (Daktarin), are usually applied once or twice daily. The duration of treatment is approximately two to four weeks. The effects are based on the inhibition of the synthesis of ergosterol, an essential component of the fungal cell membrane by inhibiting the enzyme lanosterol demethylase.
Terbinafine:
- Terbinafine (Lamisil, generic) needs to be applied only once a day for a week. There is even a film-forming solution available that is administered locally only once. Terbinafine also suppresses ergosterol synthesis in fungi, but inhibits a different enzyme, squalene epoxidase.
Other drugs:
- Dyes (e.g. gentian violet).
- Disinfectants (e.g., povidone–iodine).
- Undecylenic acid
- Keratolytics to dissolve the cornea
- Glucocorticoids to inhibit inflammation.
Prevention
- Wear bathing sandals in the swimming pool or wellness.
- Dry the feet well and keep them clean, dry and cool
- Air permeable footwear
- Treat hyperhidrosis
- Wash socks at high temperatures
- Wear clean socks and change at least once, if necessary several times a day
- Medication prevention, shoe sprays
