Athlete's Foot.

 

Definition:

Athlete's Foot is a fungal infection occuring firstly between the toes, although can spread to other areas of the foot and toenails. It is caused by a fungus called Tinea pedis. These fungi usually live on the skin, but in the right conditions can invade, multiply and cause infection, often in sports players. It is most prevalent in adolescents and young adults.

 

Causes:

Athlete's Foot is a highly contagious condition, which is easily spread from person to person. The fungi flourish in the warm, moist environment between the toes. Small pieces of skin are shed from the feet which can be picked up by others when walking barefoot; as such it is often picked up from damp changing rooms or swimming pool floors.

 

 

Presentation:

Usually symptoms firstly occur between the fourth and fifth toes. The skin

between the toes becomes boggy and white, layers of skin then come away

leaving red, itchy skin underneath. It may also crack and peel.

 

Can usually be linked to patient keeping their feet in warm, moist

environment.

 

Sources are divided as to whether the condition has a distinctive odour.

 

Although not usually a serious infection, if left untreated athlete's foot can

spread to other areas of the foot and the toenails, which my appear

discoloured, thick and white.

 

 

Differential Diagnosis:

The severity of the athlete's foot may be obvious if the skin is weeping-

this indicates the infection may have been present for a while.

 

If the toenails are discoloured this may also be an indication that the infection has been active for a while, and may need referral to a GP.

 

Check for people with diabetes- they should be encouraged to visit a chiropodist regularly as they are at a higher risk of foot ailments.

 

 

Treatment:

Firstly, feet should be washed daily with soap and then dried thoroughly.

Following this, an antifungal treatment can then be applied.

 

For example, imidazole (Daktarin Cream) should be applied twice a day

for ten days after all signs of infection have disappeared. Daktarin powder

can also be used as prevention once the infection is gone.

 

If the imidazole does not work, terbinafine products may be considered

such as Lamisil cream before referral to a GP. Lamisil cream may also

be considered for difficult to treat cases, such as when the infection has

spread onto the top and bottom of the foot. 

 

 

Self Help Advice:

Wash feet regularly and dry them well afterwards.

 

Treat shoes and socks with talcum powder.

 

Wear cotton socks.

 

Allow feet to 'breathe' as much as possible.

 

Protect feet in public swimming pools or showers by wearing flip flops.

 

 

Sample Question:

 i) Which of the following is applied once daily?

 ii) Which of the following is applied once weekly?

 

a) hydrocortisone

b) clotrimazole

c) amorolfine

d) tolnaftate

e) bifonazole

 

Answers to all sample questions can be found by following the link under the Test Yourself tab.