Athlete's foot natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[2]
Natural History
- Tinea pedis usually presents as a chronic infection due to its mild symptoms.
- Since the infection is limited to the stratum corneum, it is easy to treat with topical medication[1].
- However, chronic cases may require systemic therapy.
Complications
- Long standing tinea pedis infections cause maceration, scaling and breaks/tears in the skin barrier which allow bacterial infection to seep in.
- Bacterial skin infections such as the following are common
- Complications are usually seen in patients who are immobile (stroke/ hemiplegia), diabetes, chronic edema of the feet and immunocompromised patients.
- Rarely, even fungal osteomyelitis can result from a long standing infection, coupled with other risk factors such as immunosuppression or immobility.[2]
Dermatophytid reaction
- Dermatophytid reaction (also called identity or id reaction) is a dermatological complication of a fungal infection, like tinea pedis, wherein, an infection of the feet or toes produces an allergic skin reaction on another part of the body which is unaffected, such as the fingers.
- This is not as a result of touching the infected area.
- The cause is postulated to be circulating antibodies to the fungal antigens or cytotoxic T cells which affected an unrelated patch of skin away from the site of primary infection.[3]
Prognosis
- Athlete's foot infections range from mild to severe and may last a short or long time.
- Generally, underlying conditions such as immunodeficiency etc dictate the prognosis of tinea pedis infection.
- Prognosis is usually good in healthy people with no underlying conditions and they only require a short course of topical anti fungal creams.
- They may persist or recur, but they generally respond well to treatment.
- Long-term medication and preventive measures may be needed in some cases
References
- ↑ Morimoto K, Tanuma H, Kikuchi I, Kusunoki T, Kawana S (2004). "Pharmacokinetic investigation of oral itraconazole in stratum corneum level of tinea pedis". Mycoses. 47 (3–4): 104–14. doi:10.1046/j.1439-0507.2003.00952.x. PMID 15078426.
- ↑ Vanhooteghem O, Szepetiuk G, Paurobally D, Heureux F (2011). "Chronic interdigital dermatophytic infection: a common lesion associated with potentially severe consequences". Diabetes Res Clin Pract. 91 (1): 23–5. doi:10.1016/j.diabres.2010.09.016. PMID 21035887.
- ↑ Sorey W (2009). "Diagnosis: Dermatophytid reaction (Id reaction). Commentary". Clin Pediatr (Phila). 48 (3): 335. PMID 19367834.