​Dermatology - Tinea Pedis

​Dermatology - Tinea Pedis 
Tinea Pedis 
A particular class of fungus known as dermatiophytes is responsible for the infection of keratinized cutaneous tissues that causes tinea; arthrospores from these species can live for up to a year in skin scales.
The most prevalent ways for transmission are from person to person, from animals, and, less frequently, via soil. The majority of tinea pedis cases start in infancy or early adulthood. The environment, occlusive shoes, and hyperhidrosis are risk factors.

The duration of tinea pedis can range from months to years or even a lifetime. It is frequently accompanied by a history of tinea unguium in the toenails and is associated with tinea in other locations. Usually asymptomatic, pruritus can occur. Bacterial infections can recur later.
Damage
The lesions are macerated, well-defined, erythematous, scaling, and may or may not have bulla.
There may be bulla development or fissuring in the interdigital space. There are tiny papules on the edge, fine white scaling, and hyperkeratosis on the remaining portion of the foot. Any pattern can affect one or both feet, but bilateral involvement is more typical.
In the event of a subsequent infection or if interdigital tinea spreads to the plantar and lateral foot, ulceration may result.
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Fungal hyphae can be seen by direct microscopy of skin scrapings that have been taken using a no. 15 scalpel blade, the edge of a glass microscope slide, or a toothbrush (cervical or tooth brush) and covered with a drop of potassium hydroxide (KOH). Erythasma, pitted keratolysis, psoriasis, and eczematous dermatitis (dyshidrotic, atopic, allergic contact) are among the conditions included in the differential.

Use imidazole powder, benzoyl peroxide wash, and dry skin to stop recurrences. Take care of any concurrent nail infections.
Use allylamine lotion (naftifin, terbinafine); naphthionate ointment (tolnaftate); imidazole creams (clotrimazole, miconazole, ketoconazole, econazole, oxiconizole, suconizole, sertaconazole); or substituted pyridine (ciclopirox olamine).
Among oral antidermophytic agents, Systemic Terbinafine 250-mg tablet is the most effective allylamine. Fluconazole 100-, 150-, or 200-mg pills or oral suspension (10 or 40 mg/mL) are substitutes for itraconazole 100-mg capsules or oral solution (10 mg/mL).