Athlete's foot natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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 a 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. They may persist or recur, but they generally respond well to treatment. Long-term medication and preventive measures may be needed.
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.