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Athlete's foot or tinea pedis
Classification and external resources
Pale, flaky & split skin of athlete's foot in a toe web space
ICD-10 B35.3
ICD-9 110.4
DiseasesDB 13122
MedlinePlus 000875
eMedicine derm/470 

Athlete's foot, also called Tinea Pedis, is a parasitic fungal infection of the epidermis of the human foot. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings A00-A79 - Bacterial infections and other intestinal infectious diseases and STDs (A00-A09 Intestinal Infectious diseases ( The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Parasitism is a type of symbiotic relationship between Organisms of different Species. A fungus (ˈfʌŋgəs is a eukaryotic Organism that is a member of the kingdom Fungi (ˈfʌndʒaɪ Epidermis is the outermost layer of the Skin. It forms the waterproof protective wrap over the body's surface and is made up of stratified squamous Epithelium with The term "athlete's foot" refers to the disease and not the organism (fungus) that causes it. Several different fungi, called dermatophytes, can cause tinea pedis. A fungus (ˈfʌŋgəs is a eukaryotic Organism that is a member of the kingdom Fungi (ˈfʌndʒaɪ A dermatophyte is a parasitic fungus ( Mycosis) that infects the skin Moreover, a fungus species that causes athlete's foot can also cause, for example, jock itch (tinea cruris). Tinea cruris, also known as jock itch (American English Dhobi itch or scrot rot (British English is a fungal infection of the It is typically caused by a mould[1] (but in some cases a yeast) that grows on the surface of the skin and then into the living skin tissue itself, causing the infection. WikipediaManual_of_Style#National_varieties_of_English --> Molds (or It usually occurs between the toes, but in severely lasting cases may appear as an extensive "moccasin" pattern on the bottom and sides of the foot. The malady more commonly affects males than females. [2] Tinea pedis is estimated to be the second most common skin disease in the United States, after acne. Acne vulgaris (commonly called acne) is a Skin disease caused by changes in the Pilosebaceous units (skin structures consisting of a Hair follicle [3] Up to 15% of the U. S. population may have tinea pedis. [4]

Contents

Causes

The body normally hosts a variety of saprotrophic micro-organisms that rapidly cause infection. An infection is the detrimental Colonization of a host Organism by a foreign Species. Athlete's foot is a layman's description of a skin fungal infection, and is medically referred to as tinea pedis. The term " layman " originated from the use of the term Laity, but over the centuries changed definition to mean a person who is a non-expert in a given field of It may be associated with several different fungi, including yeasts. The most common fungi causing tinea pedis are Trichophyton rubrum and T. Trichophyton rubrum is a Fungus that is the most common cause of Athlete's foot, Jock itch and Ringworm. mentagrophytes. Fungi that involve the skin are termed dermatophytes and the resulting infections are called dermatophytosis. A dermatophyte is a parasitic fungus ( Mycosis) that infects the skin Dermatophytosis is a group of Mycosis infections of the Skin caused by parasitic fungi ( Dermatophytes)

Symptoms

Intertrigo between toes
Intertrigo between toes

Athlete's foot causes scaling, flaking and itching of the affected skin. Blisters and cracked skin may also occur, leading to exposed raw tissue, pain, swelling and inflammation. Secondary bacterial infection can accompany the fungal infection, sometimes requiring a course of oral antibiotics. In modern usage an antibiotic is a Chemotherapeutic agent with activity against Microorganisms such as Bacteria, fungi or Protozoa [5][6]

The infection can be spread to other areas of the body, such as the armpits, knees, elbows, and the groin, and usually is called by a different name once it spreads (such as tinea corporis on the body or limbs and tinea cruris (jock itch or dhobi itch) for an infection of the groin). In Human anatomy, the groin areas are the two creases at the junction of the Torso with the Legs on either side of the Pubic Tinea corporis is a superficial fungal infection ( Dermatophytosis) of the arms and legs especially on Glabrous skin, however it may occur on Tinea cruris, also known as jock itch (American English Dhobi itch or scrot rot (British English is a fungal infection of the

Tinea pedis most often manifests between the toes, with the webspace between the fourth and fifth digits most commonly afflicted. [7][8][9]

Diagnosis

Diagnosis can be performed by a pharmacist, general practitioner and by specialists of dermatologist or podiatrist. Pharmacists are Health professionals who practice the art and science of Pharmacy. A general practitioner, or GP is a medical practitioner who provides Primary care and specializes in Family medicine. Dermatology (from Greek grc δέρμα derma, "skin" and grc -λογία -logia) is a branch of Medicine dealing with Podiatry or podiatric medicine is a field of Healthcare devoted to the study and treatment of disorders of the Foot, Ankle, and the "anatomical

Athlete's foot can usually be diagnosed by visual inspection of the skin, but where the diagnosis is in doubt direct microscopy of a potassium hydroxide preparation (known as a KOH test) may help rule out other possible causes, such as eczema or psoriasis. Microscopy is the technical field of using microscopes to view samples or objects The KOH test is a procedure in which Potassium hydroxide (KOH is used to detect fungi by dissolving human cells in a culture Eczema (from Greek έκζεμα) is a form of Dermatitis, or Inflammation of the Epidermis. Psoriasis (səˈraɪəsɪs ( suh-RI-uh-sus) is a non-contagious disorder which affects the Skin and Joints It commonly causes red scaly [10] A KOH preparation is performed on skin scrapings from the affected area. The KOH preparation has an excellent positive predictive value, but occasionally false negative results may be obtained, especially if treatment with an anti-fungal medication has already begun. In Statistics, the terms Type I error (also α error, or false positive) and type II error ( β error, or a false negative [7]

If the above diagnoses are inconclusive or if a treatment regimen has already been started, a biopsy of the affected skin (i. A biopsy (in Greek: βίος life and όψη look/appearance is a Medical test involving the removal of cells or tissues e. a sample of the living skin tissue) can be taken and histological examination of the tissue performed. Histology (from the Greek = 'tissue' is the study of the microscopic anatomy of cells and tissues of Plants and

A Wood's lamp, although useful in diagnosing fungal infections of the hair (Tinea capitis), is not usually helpful in diagnosing tinea pedis since the common dermatophytes that cause this disease do not fluoresce under ultraviolet light. A Wood's lamp is a diagnostic tool used in Dermatology by which Ultraviolet light is shone (at a wavelength of approximately 365 nanometers onto the skin of the patient Tinea capitis is a superficial fungal infection ( Dermatophytosis) of the Scalp. [7] However, it can be useful for determining if the disease is due to a non-fungal source.

Transmission

Transmission from person to person

Athlete's foot is caused by a parasitic fungus and is a communicable disease. An infectious disease is a clinically evident Disease resulting from the presence of Pathogenic microbial agents including Pathogenic viruses Pathogenic [11] It is typically transmitted in moist environments where people walk barefoot, such as showers, bath houses, and locker rooms. A shower (also called shower bath is a booth for washing usually in a Bathroom, having an overhead nozzle that sprays water down on the body Public baths originated from a communal need for cleanliness Often the term public is misleading to some people as they will have restrictions based upon who can use the facility A changeroom [12][2][11] It can also be transmitted by sharing footwear with an infected person, or less commonly, by sharing towels with an infected person. Footwear consists of Garments worn on the feet, for protection against the environment and Adornment.

Transmission to other parts of the body

The various parasitic fungi that cause athlete's foot can also cause skin infections on other areas of the body, most often under toenails (Onychomycosis) or on the groin (tinea cruris). A nail is a horn -like structure at the end of an animal's Finger or Toe. Onychomycosis means fungal infection of the nail. It is the most common disease of the nails and constitutes about a half of all nail abnormalities Tinea cruris, also known as jock itch (American English Dhobi itch or scrot rot (British English is a fungal infection of the

Prevention

The practices given in this section do not only help prevent spread of the fungus, they can also help greatly in managing and curing athlete's foot in an individual by reducing or eliminating re-exposure to the fungus in one's home environment.

The fungi that cause athlete's foot can live on shower floors, wet towels, and footwear. Athlete's foot is caused by a fungus and can spread from person to person from shared contact with showers, towels, etc. Hygiene therefore plays an important role in managing an athlete's foot infection. Since fungi thrive in moist environments, it is very important to keep feet and footwear as dry as possible.

Prevention measures in the home

The fungi that cause athlete's foot live on moist surfaces and can be transmitted from an infected person to members of the same household through secondary contact. [13] By controlling the fungus growth in the household, transmission of the infection can be prevented.

Bathroom hygiene

Frequent laundering

Avoid sharing

Prevention measures in public places

Personal prevention measures

Treatments

There are many conventional medications (over-the-counter and prescription) as well as alternative treatments for fungal skin infections, including athlete's foot. Important with any treatment plan is the practice of good hygiene. Several placebo controlled studies report that good foot hygiene alone can cure athlete's foot even without medication in 30-40% of the cases. [14] However, placebo-controlled trials of allylamines and azoles for athlete’s foot consistently produce much higher percentages of cure than placebo. Allylamine is an Organic compound with the formula C3H5NH2 This colourless liquid is the simplest stable unsaturated Amine An azole is a class of five-membered Nitrogen Heterocyclic ring compounds containing at least one other noncarbon atom nitrogen sulfur or oxygen [15]

Conventional treatments

Conventional treatment typically involves daily or twice daily application of a topical medication in conjunction with hygiene measures outlined in the above section on prevention. Athlete's foot, also called Tinea Pedis, is a Parasitic fungal infection of the epidermis of the human foot Keeping feet dry and practicing good hygiene is crucial to preventing reinfection. Severe or prolonged fungal skin infections may require treatment with oral anti-fungal medication.

Topical medications

Main article: Antifungal drug

The fungal infection is often treated with topical antifungal agents, which can take the form of a spray, powder, cream, or gel. An antifungal drug is Medication used to treat fungal Infections such as Athlete's foot, Ringworm, Candidiasis (thrush An antifungal drug is Medication used to treat fungal Infections such as Athlete's foot, Ringworm, Candidiasis (thrush The most common ingredients in over-the-counter products are Miconazole nitrate (2% typical concentration in the United States) and Tolnaftate (1% typ. Over-the-counter (OTC drugs are medicines that may be sold without a prescription, in contrast to Prescription drugs The name "over-the-counter" Miconazole is an Imidazole Antifungal agent developed by Janssen Pharmaceutica, and commonly applied topically (to the Skin) or Mucus Tolnaftate is a synthetic over-the-counter Anti-fungal agent It may come as a cream powder spray or Liquid aerosol, and is used to treat Jock itch in the U. S. ). Terbinafine, marketed as Lamisil is another over-the-counter drug. Terbinafine hydrochloride ( Lamisil in Australia Belgium Brazil Canada France Germany Hungary Romania United Kingdom and United States also sold under the name There exists a large number of prescription antifungal drugs, from several different drug families. These include ketaconazole, itraconazole, naftifine, nystatin, caspofungin. Ketoconazole is a synthetic Antifungal drug used to prevent and treat skin and fungal infections especially in immunocompromised patients such as those Itraconazole (marketed as Sporanox by Janssen Pharmaceutica) invented in 1984 is a Triazole Antifungal agent that is prescribed to patients Naftifine (brand name Naftin is an allylamine Antifungal drug for the topical treatment of tinea pedis tinea cruris and tinea corporis (fungal infections Nystatin is a polyene Antifungal drug to which many Molds and Yeast infections are sensitive including ''Candida'' spp Caspofungin ( INN) (brand name Cancidas worldwide is an Antifungal drug the first of a new class termed the Echinocandins from Merck & Co Studies show that Allylamines (Terbinafine, Amorolfine, Naftifine, Butenafine) cure slightly more infections than azoles (Miconazole, ketaconazole, Clotrimazole, itraconazole, sertaconazole, etc. Terbinafine hydrochloride ( Lamisil in Australia Belgium Brazil Canada France Germany Hungary Romania United Kingdom and United States also sold under the name Amorolfine (or amorolfin) is an allylamine Antifungal drug that inhibits D14 reductase and D7-D8 isomerase, which depletes Ergosterol Naftifine (brand name Naftin is an allylamine Antifungal drug for the topical treatment of tinea pedis tinea cruris and tinea corporis (fungal infections Butenafine hydrochloride is a synthetic Benzylamine Antifungal, marketed under the trade names Mentax, Butop (India and is the active ingredient Miconazole is an Imidazole Antifungal agent developed by Janssen Pharmaceutica, and commonly applied topically (to the Skin) or Mucus Ketoconazole is a synthetic Antifungal drug used to prevent and treat skin and fungal infections especially in immunocompromised patients such as those Clotrimazole is an Antifungal medication commonly used in the treatment of fungal infections of both humans and animals such as vaginal yeast infections and Itraconazole (marketed as Sporanox by Janssen Pharmaceutica) invented in 1984 is a Triazole Antifungal agent that is prescribed to patients Sertaconazole nitrate ( Ertaczo) is an Antifungal medication of the Imidazole class ). [15]

The time line for cure may be long, often 45 days or longer. The recommended course of treatment is to continue to use the topical treatment for four weeks after the symptoms have subsided to ensure that the fungus has been completely eliminated. However, because the itching associated with the infection subsides quickly, patients may not complete the courses of therapy prescribed.

Anti-itch creams are not recommended as they will alleviate the symptoms but will exacerbate the fungus; this is due to the fact that anti-itch creams typically enhance the moisture content of the skin and encourage fungal growth. For the same reason, some drug manufacturers are using a gel instead of a cream for application of topical drugs (for example, naftin and lamisil). Naftifine (brand name Naftin is an allylamine Antifungal drug for the topical treatment of tinea pedis tinea cruris and tinea corporis (fungal infections Terbinafine hydrochloride ( Lamisil in Australia Belgium Brazil Canada France Germany Hungary Romania United Kingdom and United States also sold under the name Novartis, maker of lamisil claims that gel penetrates the skin more quickly than cream. Novartis International AG is a multinational Pharmaceutical company based in Basel Switzerland that manufactures drugs such as Clozapine

Some topical applications such as carbol fuchsin (also known in the US as Castellani's paint), often used for intertrigo, work well but in small selected areas. Carbol fuchsin, carbol-fuchsin, or carbolfuchsin, is a mixture of Phenol and Basic fuchsin, used in Bacterial Staining An intertrigo is an Inflammation ( Rash) of the body folds (adjacent areas of Skin) This red dye, used in this treatment like many other vital stains, is both fungicidal and bacteriocidal; however, because of the staining it is cosmetically undesirable. Staining is an auxiliary Technique used in Microscopy to enhance contrast in the microscopic image Fungicides are Chemical compounds or biological organisms used to kill or inhibit fungi or fungal spores A bactericide or bacteriocide is a substance that kills bacteria and preferably nothing else For many years gentian violet was also used for bacterial and fungal infections between fingers or toes. Gentian violet ( Crystal violet, Methyl Violet 10B, hexamethyl Pararosaniline chloride is an antifungal agent,the primary agent used in the

Whitfield's Ointment (benzoic and salicylic acid) is an older treatment that still sees occasional use. Whitfield's Ointment is 6% Salicylic acid and 12% Benzoic acid in a suitable base such as Lanolin or Vaseline.

Undecylenic acid (castor oil derivative) is a known fungicide that can be used for fungal skin infections such as athlete's foot. Undecylenic / Undecenoic Acid is an organic unsaturated Fatty acid derived from natural Castor oil. Castor oil is a Vegetable oil obtained from the Castor bean (technically castor seed as the castor plant Ricinus communis, is not a member of

If the fungal invader is not a dermatophyte but a yeast, other medications such as fluconazole may be used. Fluconazole ( INN) (fluːˈkɒnəzoʊl is a Triazole Antifungal drug used in the treatment and prevention of superficial and systemic fungal infections Typically fluconazole is used for candidal vaginal infections moniliasis but has been shown to be of benefit for those with cutaneous yeast infections as well. Candidiasis, commonly called yeast infection or thrush, is a Fungal infection (mycosis of any of the Candida species of which The most common of these infections occur in the web spaces (intertriginous) of the toes and at the base of the fingernail or toenail. The hall mark of these infections is a cherry red color surrounding the lesion and a yellow thick pus.

Oral medications

Oral treatment with griseofulvin was begun early in the 1950s. Griseofulvin (also known as Grisovin is an Antifungal drug. It is used both in animals and in humans to treat Ringworm infections of the skin and nails The 1950s Decade refers to the years of 1950 to 1959 inclusive Because of the tendency to cause liver problems and to provoke aplastic anemia the drugs were used cautiously and sparingly. Over time it was found that those problems were due to the size of the crystal in the manufacturing process and microsize and now ultramicrosize crystals are available with few of the original side effects.

For severe cases, the current preferred oral agent in the UK,[16] is the more effective terbinafine. Terbinafine hydrochloride ( Lamisil in Australia Belgium Brazil Canada France Germany Hungary Romania United Kingdom and United States also sold under the name [17] Other prescription oral antifungals include itraconazole and fluconazole. Itraconazole (marketed as Sporanox by Janssen Pharmaceutica) invented in 1984 is a Triazole Antifungal agent that is prescribed to patients Fluconazole ( INN) (fluːˈkɒnəzoʊl is a Triazole Antifungal drug used in the treatment and prevention of superficial and systemic fungal infections [5]

Alternative treatments

Witch hazel

Witch hazel has been alleged to cure athlete's foot in as few as three days. Witch-hazel ( Hamamelis) is a Genus of Flowering plants in the family Hamamelidaceae, with two species in North America

Topical oils

Symptomatic relief from itching may be achieved after topical application of tea tree oil or crocodile oil, probably due to its involvement in the histamine response,[18] however the efficacy of Tea tree oil in the treatment of athlete's foot (achieving mycological cure) is questionable. Tea tree oil is an extraction from the Melaleuca tree Tea tree oil or melaleuca oil is a clear to very pale golden color Essential oil Histamine is a Biogenic amine involved in local immune responses as well as regulating physiological function in the gut and acting as a Neurotransmitter [19][20]

Onion extract

A study of the effect of 3% (v/v) aqueous onion extract was shown to be effective in laboratory conditions against Trichophyton mentagrophytes and T. rubrum. [21]

Rubbing alcohol and hydrogen peroxide

Direct application of rubbing alcohol and/or hydrogen peroxide after bathing can aid in killing the fungus at the surface level of the skin and will help prevent a secondary (bacterial) infection from occurring. Rubbing alcohol USP / BP is a liquid prepared and used primarily for Topical application Hydrogen peroxide (H2O2 is a very pale blue liquid which appears colorless in a dilute solution slightly more Viscous than water In addition, soaking the feet in a bath of 70% rubbing alcohol will help dry the skin out, and likewise kill the invading fungus. The alcohol is not, however, effective against spores.

Hair dryer

Since fungi grow in moist conditions, it is very important to dry the feet well after bathing. A hair dryer can be used to aid the drying process, or to dry feet which have become slightly moist in between showers or baths. A blowdryer or hairdryer is an Electromechanical device designed to blow cool or hot Air over wet or damp Hair, in order to accelerate the

Baking soda

Rubbing feet with a baking soda paste and/or sprinkling baking soda in shoes is thought to help by changing pH. [22]

Household bleach (not recommended)

The use of household bleach as a direct topical application or soak for tinea pedis is not recommended, as it is a well documented irritant (clearly labelled in the United Kingdom as "Harmful" by COSHH). The Control of Substances Hazardous to Health Regulations 2002 is a United Kingdom Statutory Instrument that stipulates general requirements on employers to protect It is used diluted as an environmental decontaminatant to prevent the spread of dermatophytes between animals, and from animals to humans.

Urinating

Some people believe that urinating on the infected area can help relieve symptoms and clear the fungal infection.

Origin of the term "athlete's foot"

The Oxford English Dictionary documents written usage of the term in 1928 (1928 Lit. The Oxford English Dictionary ( OED) published by the Oxford University Press (OUP is a comprehensive Dictionary of the English Digest 22 December. Events 1790 - The Turkish fortress of Izmail is stormed and captured by Suvorov and his Russian armies 16/1), which seems to undercut the claim by W. F. Young, Inc. that the term "athlete's foot" was originated, rather than simply popularized, as part of an advertising campaign for Absorbine Jr. during the 1930s. The 1930s were described as an abrupt shift to more radical and conservative lifestyles as countries were struggling to find a solution to the Great Depression. [23]

See also


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External links

Links are organized by subsection, and then listed in alphabetical order. An antifungal drug is Medication used to treat fungal Infections such as Athlete's foot, Ringworm, Candidiasis (thrush Dermatophytosis is a group of Mycosis infections of the Skin caused by parasitic fungi ( Dermatophytes) Ringworm (also called serpigo) is an infection of the skin characterized by a reddish to brownish raised or bumpy patch of skin that may be lighter in the center

General medical information

Photos

Organizations

Dictionary

athlete's foot

-noun

  1. (pathology) A fungal infection of the skin of the foot, usually between the toes, caused by the pathogen fungi. Scientific name: tinea pedis.
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