Interdigital candidiasis

Erosio interdigitalis candidomycetica, Erosio interdigitalis blastomycetica.

Infection of the interdigital spaces with Candida spp. (mostly C.albicans)

• Division:
  • Dry form
  • Macerative form

• Exciter:
  • C. albicans
  • C. parapsilosis
  • Candida guilliermondii

• Candida spp. can settle (especially with increased moisture exposure) between the toes/fingers. Especially between the 3rd-4th finger and the 2nd-4th toe

• Predisposing factors:
  • Hyperhidrosis
  • occlusive footwear
  • poor foot hygiene
  • ↑ wet work
  • obesity
  • Diabetes mellitus

Macerations, rhagades, whitish swelling of the str. corneum.

• Clinic
• Myco. examination of skin scales

• Erysipelas
• Gram-negative foot infection

• Avoiding occlusive footwear
• Consistently keeping the spaces between the toes dry to avoid maceration
• Regular foot care
• Prevent rhagades by re-lubricating with a foot cream containing urea
• Therapy of the interdigital space. Co-treatment of the hands or feet
• Limitation of predisposing factors
• Keeping the hands and feet dry
• If possible, additional linen pads should be placed in the spaces between the toes
• Stockings should be changed daily and washed at a minimum of 60°C
Sandals, flip flops or bathing shoes should be worn in public showers/baths

Topical therapy

• Clotrimazole cream paste
• Ciclopirox lsg.
• Miconazole tincture
• Note: Cream pastes and lsg. are drying. Tinea pedis or T. manum should be treated with cream
• Local therapy should be given for at least two weeks beyond the disappearance of the skin lesions

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2. Luo DQ, Yang W, Wu LC, Liu JH, Chen WN. Interdigital ulcer: an unusual presentation of Candida infection. Mycoses 2011;54:e780-4. 
3. Chanussot C, Arenas R. [Interdigital and foot fungal infection in patients with onychomycosis]. Rev Iberoam Micol 2007;24:118-21. 
4. Satchell AC, Saurajen A, Bell C, Barnetson RS. Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: a randomized, placebo-controlled, blinded study. Australas J Dermatol 2002;43:175-8. 
5. Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G. Dermatology for the practicing allergist: Tinea pedis and its complications. Clin Mol Allergy 2004;2:5.