Tinea pedis

Last Updated: 2022-07-29

Author(s): Anzengruber F., Navarini A.

ICD11: 1F28.2

Athlete's foot, tinea pedum.

Fungal disease of the feet.

  • Classification
    • Dyshidrotic type
    • Hyperkeratotic-rhagadiform type
    • Interdigital type
    • Moccasin type
    • Oligosymptomatic type

Incidence: 20% - 80%

  • Pathogen
    • Trichophyton rubrum (approx. 80%)
    • Trichophyton mentagrophytes (approx. 10%)
    • Epidermophyton floccosum (approx. 4%)
    • Microsporum canis
    • Microsporum gypseum
  • Predisposing factors
    • Foot deformities
    • Frequent wearing of tight shoes
    • Trauma
    • Hyperhidrosis
    • Disorders of blood circulation (acrocyanosis)
    • Diabetes mellitus
    • Peripheral neuropathy
    • Familial disposition
    • Male gender
  • Infection by dermatophytes (see above). Transmission can occur from person to person or via the floor (indoor swimming pool)

  • Dyshidrotic foot eczema: Palmar dyhidrotic vesicles localised especially in the arch of the foot
  • Interdigital type: rhagades and dry scales appear interdigitally
  • Moccasin type: Whitish, scaly plaques. Distribution resembles moccasins
  • Hyperkeratotic-rhagadiform type: Pronounced hyperkeratoses are in the foreground. There is often painfulness when walking if rhagades are present.
  • Oligosymptomatic type: Interdigital minimal redness and fine scaling. Hyperkeratosis may be seen on the edges of the feet

  • Clinic
  • Detection of pathogens (scales, pustule contents: native and culture; biopsy)

  • Erysipelas
  • Contact allergy
  • Tinea unguium

  • Clotrimazole spray 2-3x / week
  • CAVE: Prolonged topical antifungal treatment may result in gram-negative forefoot infection (expulsion of gram-positive flora)

Chronic progression.

Therapy of 1st choice according to Lebwohl  
Clotrimazole A
Miconazole A
Therapy of 2nd choice according to Lebwohl  
Terbinafine 1% A
Ciclopirox A
Therapy of 3rd choice according to Lebwohl  
Photodynamic therapy D
Systemic  
Terbinafine A
Itraconazole A
Fluconazole A
Griseofulvin A

 

  • Topical therapy
  • Clotrimazole cream
  • Terbinafine (cream 1%, solution 1%, spray)
  • Ketoconazole cream (cream 2%)
  • Amorolfin cream (0.25% cream)
  • Griseofulvin cream: not on the market in Switzerland
  • Bifonazole cream: not on the market in Switzerland
  • Econazole (cream 1%)
  • Ciclopirox (cream or solution)

 

 

  • The spaces between the toes should always be kept dry
  • Walking on bare feet should be avoided
  • As fungi can also be found in socks and shoes, we recommend: Wash all! Socks with at least 60°C
  • Consistent disinfection of the footwear (e.g.: with commercially available disinfectant spray such as: Octenidin)

  1. Aste N, Pau M, Aste N, Biggio P. Tinea pedis observed in Cagliari, Italy, between 1996 and 2000. Tinea pedis in Cagliari, Italien, zwischen 1996 und 2000. Mycoses 2003;46:38-41.
  2. Lachapelle JM, De Doncker P, Tennstedt D, Cauwenbergh G, Janssen PA. Itraconazole compared with griseofulvin in the treatment of tinea corporis/cruris and tinea pedis/manus: an interpretation of the clinical results of all completed double-blind studies with respect to the pharmacokinetic profile. Dermatology 1992;184:45-50.
  3. Lacroix C, Baspeyras M, de La Salmoniere P, et al. Tinea pedis in European marathon runners. Journal of the European Academy of Dermatology and Venereology 2002;16:139-42.
  4. Lupa S, Seneczko F, Jeske J, Glowacka A, Ochecka-Szymanska A. Epidemiology of dermatomycoses of humans in Central Poland. Part III. Tinea pedis. Mycoses 1999;42:563-5.
  5. 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.
  6. Goldstein, A. (2016). Dermatophyte (tinea) infections. Uptodate.com. Retrieved 30 May 2016, from http://www.uptodate.com/contents/dermatophyte-tinea-infections?source=search_result&search=tinea+corporis&selectedTitle=1~51