What is tinea pedis?
Tinea pedis usually occurs in males and adolescents/young adults, but can also affect females, children and older people. Infection is usually acquired by direct contact with the causative organism — for example, using a shared towel or walking barefoot in a public change room. Other risk factors include excessive sweating, occlusive footwear, underlying immunodeficiency and poor peripheral circulation.
What are the clinical features of tinea pedis?
There are usually three main presentations:
- Itchy erosions and/or scales between the toes, especially between the 4th and 5th toes
- Scale covering the sole and sides of the feet (hyperkeratotic/moccasin type)
- Small to medium-sized blisters on the inner aspect of the foot (vesiculobullous type)
How is tinea pedis diagnosed?
The diagnosis can be made clinically by examining characteristic features, or confirmed by scraping skin and examining it under a microscope at a pathology lab.
How is tinea managed?
Prevention
General measures include drying feet thoroughly, especially between toes, avoiding occlusive footwear for long periods, and using sandals in communal showers. Treating shoes with antifungal powder is also recommended.
Treatment
Topical antifungal treatments should be applied once or twice daily for 2 to 4 weeks. These include azoles (e.g. miconazole), allylamines (e.g. terbinafine), and ciclopirox. For those who do not respond to topical treatments, oral antifungal agents may be required.
A topical keratolytic cream containing salicylic acid and urea may be beneficial in treating hyperkeratotic variants of tinea pedis.
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