Tinea pedis

Last Updated: 2021-10-15

Author(s): Anzengruber, Navarini

Athlete's foot, tinea pedum, athlete's foot. 

Fungal disease of the feet.

  • categorisation 
    • Dyshidrotic guy.
    • Hyperkeratotic-rhagadiform type.

    • Interdigital type.
    • Moccasin guy.
    • Oligosymptomatic type. 

Incidence: 20%- 80%.

  • Causative organism 
    • Trichophyton rubrum (about 80%).
    • Trichophyton mentagrophytes (about 10%).
    • Epidermophyton floccosum (approx. 4%).

    • Microsporum canis.
    • Microsporum gypseum.
  • Predisposing factors:
  • Foot malpositions..
  • Frequent wearing of tight shoes.
  • Traumas.
  • Hyperhidrosis.
  • Circulatory disorders (acrocyanosis).
  • Diabetes mellitus.
  • Peripheral neuropathy.

  • Family disposition.
  • Male gender.
  • Infection by dermatophytes (see above). The transmission can take place from person to person or via the floor (indoor swimming pool).
  • Dyshidrotic foot eczema type: Plantar, dyhidrotic vesicles located particularly in the arch of the foot. 
  • Interdigital type: Interdigital rhagades and dry scales. 

  • Moccasin type: Whitish, scaly plaques. The distribution reminds of moccasins.

  • Hyperkeratotic-rhagadiformer type: In the foreground are the pronounced hyperkeratoses. Often there is painfulness when walking when rhagades exist. 
  • Oligosymptomatic type: Interdigital minimal redness, and fine flaking. Hyperkeratosis can be observed at the edges of the feet.
  • Clinic.
  • Detection of pathogens (dandruff, pustules: native and culture; biopsy)   

  • Erysipelas.
  • Contact allergy.

  • Tinea unguium.
  • Canesten® (clotrimazole) spray 2-3x week.
  • CAVE: Prolonged topical antimycotic treatment can lead to a gram-negative forefoot infection (expulsion of gram-positive flora). 

Chronic course. 

Therapy of the 1st choice after Lebwohl 

 
Clotrimazole A
Miconazole A

Therapy of the 2nd choice after Lebwohl

 
Terbinafin 1% A
Ciclopirox A

Therapy of the 3rd choice after Lebwohl

 
Photodynamic Therapy D
Systemic  
          Terbinafin A
          Itraconazole A
          Fluconazole A
          Griseofulvin A

 

  • Topical Therapy
  • Clotrimazole cream (Canesten® cream)

  • Terbinafin Cream (Terbinafin® Cream 1%, Lamisil® Cream, Lamisil® Pedisan Once-Lsg. 1%, Lamisil® Spray)

  • Ketoconazole cream (Nizoral® cream 2%)

  • Amorolfine cream (Loceryl® 0.25% cream)

  • Crisesofulvin cream: not available in Switzerland

  • #Bifonazole cream: not available in Switzerland
  • Econazole cream (Pevaryl® cream 1%)
  • Ciclopirox cream (Ciclocutan® cream or similar)

 

 

  • The spaces between the toes should always be kept dry.
  • Walking barefoot should be avoided.
  • Since the socks and shoes can also contain mushrooms, we recommend: Wash all (!) socks at least 60°C.
  • Consistent disinfection of footwear (e.g.: with commercially available disinfection spray such as (e.g.: Octenisept®-Spray).

 

  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