diease

Athlete's foot


OVERVIEW OF Athlete's foot :

It is a common skin infection of the foot caused by the fungus tinea paedis a form of ringworm.It is alsoknown as interdigital mycosis.Plantar athelets foot is also known as the Moccasin foot.


EPIDEMIOLOGY :

It is common among the 15- 20% of the population.the disease is more common among the bare foot peoples.


CAUSES :

The disease mostly spread by fungus that mainly reside in the humid conditions.

The disease is also spread by contaminated towels,shoes and socks

Hyperhydrosis-increased sweating favours moist environment which inturn increases the chances of getting infection.

Dermatitis

Immunesuppresion

Swimming in contaminated water.


PATHOPHYSIOLOGY :

When the fungus gets transmitted to the pets,it gets easily transmitted to the person who comes in contact with the pet .

One way to contract athlete's foot is to get a fungal infection somewhere else on the body first. The fungi causing athlete's foot may spread from other areas of the body to the feet, usually by touching or scratching the affected area, thereby getting the fungus on the fingers, and then touching or scratching the feet. While the fungus remains the same, the name of the condition changes based on where on the body the infection is located. For example, the infection is known as tinea corporis ("ringworm") when the torso or limbs are affected or tinea cruris (jock itch or dhobi itch) when the groin is affected. Clothes (or shoes), body heat, and sweat can keep the skin warm and moist, just the environment the fungus needs to thrive.


ROUTES OF TRANSMISSION :

Athlete’s foot is very contagious and it can be transmitted by both direct and indirect contact with fomite objects The disease is widely spread to others when the people come in contact with the contaminated area. floors).

The fungus resides in the dampened areas such as bathroom,locker room and other enclosed ares.Hence it is advisable to keep clean these arear to avoid infections.

Fungi rub off of fingers and bare feet, inspite they also spread to the dead cells that undergo rejuvenation. Athlete's foot fungi and infested skin particles and flakes may spread to socks, shoes, clothes, to other people, pets (via petting), bed sheets, bathtubs, showers, sinks, counters, towels, rugs, floors, and carpets.


COMMON CLINICAL SIGNS AND SYMPTOMS :

Athlete's foot usually results in scaly red rash. The rash mainly presents in toes region. Itching is often the worst right after you take off your shoes and socks.

Blisters and formation of ulcers are also an symptom. The athelete foot mainly results in chronic dryness and scaling on the soles that extends up the side of the foot.

The infection can affect one or both feet and can spread to your hand — especially if you scratch or pick at the infected parts of your feet.

Dry skin on your toes and feet

Burning sensation between the toes.

Toe nails that are pulled away from the nail bed.

Numbness and tingling sensation to the skin.


DIAGNOSTIC :

A doctor may diagnose athlete’s foot by the symptoms. Or, a doctor may order a skin test if they aren’t sure a fungal infection is causing your symptoms.

A skin lesion potassium hydroxide exam is the most common test for athlete’s foot. A doctor scrapes off a small area of infected skin and places it in potassium hydroxide. The KOH destroys normal cells and leaves the fungal cells untouched so they are easy to see under a microscope.


TREATMENT AND PROGNOSIS :

It gets usually resolved without any medications and it is easily  curable.

  • Conventional remedy for this fungal infection involve throughly washing the hands and toes whenever it is necessary.
  • Since outer layer of the skin is damaged more topical treatment should be continued for atleast 4-6 weeeks.This time period aids in replacement of the old cels to rejuvenate new cells in all layers of the skin layer.
  • Topical treatment also does not favours the good results.The socks should be thoroughly washed and bleached with the temperature range of 60-70 degree celcius.
  • The treatment should not focus on the particular region.If one area is left for example if nail is left without providing any treatment it leads to spread of the disease to left side of the foot and again the athelets foot might reoccur.hence treatment should concerned all the resurrounding region.
  • Allylamines such as terbinafine are produce more effectiveness when compared to azoles for the treatment of athlete's foot
  • If the fungal infection takes longer duration to subside then oral treatments should be considered.
  • Topical treatments:
  • There are many topical antifungal agents which are found o be useful in the treatment of athlete's foot including
  • Micanazole,clotrimazole,Terbinafine hydrochloride,butenafine hydrochloride and undecylenic acid.
  • . The fungal infection may be treated with topicalantifungal agents, which can take the form such as  spray, powder, cream, or gel.
  • Topical application of an antifungal cream such as butenafine once daily for one week or terbinafine once daily for two weeks is effective in most cases of athlete's foot and is more effective than application of miconazole or clotrimazole.
  •  Plantar type athelete foot shows longer duration of reatment since the hyperkeratosis nature of the foot surface .Keratolytic and humectant medications such as urea salicylic acid(whitfield’s oinment), and lactic acid are useful adjunct medications and improve penetration of antifungal agents into the thickened skin.
  •  Topical glucocorticoids are sometimes prescribed to alleviate inflammation and itching associated with the infection.
  • A solution of 1% potassium permangnate dissolved in hot water is an alternative to antifungal drugs. Potassium permanganate is a salt and also it acts as an strong oxidizing agent.
  • Oral treatments
  • For complicated or reoccurrence cases  of athlete's foot oral terbinafine is more effective than griseofulvin.
  • Fluconazole or itraconazole may also be taken orally for severe athlete's foot infections. The most commonly reported adverse effect from these medications is gastrointestinal upset.

 


PROGNOSIS :

The prognosis is good when the infectious  agent is get rid off.


PREVENTION :

These tips can help you avoid athlete's foot or ease the symptoms if infection occurs:

  • Keep your feet dry, especially between your toes. Go barefoot to let your feet air out as much as possible when you're home. Dry between your toes after a bath or shower.
  • Change socks regularly. If your feet get very sweaty, change your socks twice a day.
  • Wear light, well-ventilated shoes. Avoid shoes made of synthetic material, such as vinyl or rubber.
  • Alternate pairs of shoes. Don't wear the same pair every day so that you give your shoes time to dry after each use.
  • Protect your feet in public places. Wear waterproof sandals or shoes around public pools, showers and lockers rooms.
  • Treat your feet. Use powder, preferably antifungal, on your feet daily.
  • Don't share shoes. Sharing risks spreading a fungal infection.
  • Avoid sternous exercises which might results in over sweating.

 


Recovery Period :

Recovery period takes between 2-4 weeks.


Medicines used in the Treatment :

Allylamines such as terbinafine

Micanazole,clotrimazole,Terbinafine hydrochloride,butenafine hydrochloride and undecylenic acid.

urea salicylic acid(whitfield’s oinment)

Fluconazole or itraconazole may also be taken oraly


REFERENCE :

Parijas textbook of microbiology

Anandhanarayana's textbook of microbiology

www.healthline.com

www.nhs.uk

http://www.cdc.gov.in