Athlete's foot (dermatophytosis) is an infectious disease caused by pathogenic or opportunistic fungi. With mycosis, the skin on the feet peels off and causes intense itching, and in severe cases of the disease it becomes red and swollen.
Definition of the disease
Athlete's foot, or dermatophytosis, is an infectious disease caused by a dermatophyte mold. In total, 43 species of dermatophytes are known, 30 of which lead to mycosis of the feet. Most often these are the fungi Trichophyton rubrum (90%), Trichophyton mentagrophytes and less often Epidermophyton. Mycosis of the feet is much less often caused by fungi of the genus Candida and mold Scytalidium dimidiatum, Scytalidium hyalinum.
All dermatophytes have a keratinolytic effect: they are able to dissolve keratin, the fibrous protein that forms the upper part of the skin of humans and animals. The skin is damaged.
Once on the skin, the fungi are directed to the most vulnerable places - the junctions between the cells of the epidermis. There they penetrate inside and begin to actively develop. However, fungi rarely penetrate deeper than the granular layer of the skin. They are usually limited only to the upper, keratinized tissues.
Prevalence of athlete's foot
Fungal infections of the skin, including athlete's foot, are found in all countries of the world. The share of these diseases in the structure of all dermatological diseases reaches 37-40%.
At the same time, fungal infections of the skin occur more often - in about 30% of cases.
According to dermatologists, up to 20% of the adult population suffers from athlete's foot. The pathology is found twice as often in men.
In people over 70, foot fungus is found in almost every second patient - this is explained by the fact that the elderly usually have chronic diseases associated with metabolic disorders, as well as vascular pathologies, such as varicose veins.
Infection with athlete's foot usually runs in the family - through direct skin contact with an infected person. There are also known cases of contamination when sharing clothes, shoes and household items.
The infection usually affects both feet at the same time and partly spreads to the nail plates. Without treatment, the disease can also affect the skin of the palm - usually on the working hand. This condition is called two-leg-one-arm syndrome.
Causes of foot fungus
Most often, foot fungus is caused by dermatophyte fungi - Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum. Much less often, the disease is caused by fungi of the genus Candida (Candida) and mold (Scytalidium dimidiatum, Scytalidium hyalinum).
According to some studies, the proportion of dermatophytes in the structure of the causative agents of foot mycosis is gradually decreasing. Candida fungi come to the fore.
Risk factors for developing athlete's foot:
- violation of personal hygiene;
- sharing shoes (for example, at bowling alleys, skate and ski rental shops);
- visiting public baths, swimming pools, beaches.
- climatic features: the risk of getting sick is higher in countries with subtropical and tropical climates - this is due to increased humidity and ambient temperature.
- constantly wearing closed, narrow shoes (this happens among military personnel, miners, workers in the textile industry and the metallurgical industry);
- frequent toe injuries due to flat feet, calluses, corns;
- non-compliance with sanitary rules during pedicure.
- impaired blood supply to the legs.
- immunodeficiency conditions, including HIV;
- chronic dermatitis;
- portliness;
- Diabetes;
- chronic venous insufficiency;
- taking certain medicines (systemic glucocorticosteroids).
Symptoms of foot fungus
The symptoms of mycosis of the feet, as well as the features of the treatment of the disease depend on its clinical form.
Plaque (squamous-hyperkeratotic) form of mycosis of the feet
In most cases, the causative agent of the squamous form of mycosis of the feet is the dermatophyte Trichophyton rubrum.
At the initial stage of the disease, the patient is bothered by moderate peeling of the skin between the fingers - the scales on the skin are abundant, thin and silver in color. Then, as the disease spreads to the lateral and dorsal surfaces of the legs, a characteristic inflammatory ridge appears and the skin in the affected areas thickens. Over time, the patient develops onychomycosis - nail fungus.
Diatrical (interdigital) form of mycosis of the feet
This form often develops against the background of intense sweating of the feet. The disease affects the spaces between the fingers and is accompanied by redness, swelling and wetting (softening and loosening of the skin). Corrosion and cracks often form. Many patients report itching, burning and pain.
Often, simultaneous infection of the skin of the feet with dermatophyte fungi (usually Trichophyton mentagrophytes var. interdigitale) and the bacterium Staphylococcus aureus occurs.
Dyshidrosis form of mycosis of the feet
As a rule, the causative agent of this form of mycosis of the feet is Epidermophyton floccosum (scaly epidermophyte).
The dyshidrosis form of mycosis of the feet, as a rule, is more severe and is accompanied by painful itching and pain. Blisters form on the skin with a thick covering. Merging, they form large multichambered blisters, which after opening turn into liquid pink-red erosions, and then into brown crusts.
The disease is difficult to treat and often recurs.
A characteristic feature of the dyshidrotic form is damage to the arch of the foot, the interdigital folds and the skin of the toes. The process can then spread to the heels, the lower lateral surfaces of the feet, and even the skin below the ankles.
If a bacterial infection occurs, the patient may develop a fever and the peripheral lymph nodes will be enlarged. Swelling of the leg appears and the skin on it becomes moist. Severe pain makes it difficult for the patient to walk.
Exudative-dysiduric form of mycosis of the feet
Most often, the exudative-dysidrotic form of mycosis of the feet is caused by the fungus Trichophyton rubrum (red trichophyton).
The skin between the fingers is affected first. The process then spreads to the sole, the dorsal and lateral surface of the foot and the nail plates. Blisters and erosions appear on the skin, which are then covered with crusts. The skin becomes moist and may become involved.
Deleted form of mycosis of the feet
The deleted form is identified by some researchers. It is believed to appear a few days after infection with the fungus.
The skin in the interdigital folds begins to peel. There may also be slight peeling on the soles and sides of the feet. Patients may ignore unpleasant symptoms, but still infect others.
Acute form of mycosis of the feet
The acute form of mycosis of the feet is the result of an exacerbation of the dyshidrotic or intertrigal (interdigital) form.
The disease begins acutely: a large number of blisters appear on the skin of the legs and then on the feet. The skin swells. Lumps then form on the hands and lower third of the forearms.
After the blisters open, erosions appear, surrounded by remnants of loose skin. They merge, turn into extensive weeping surfaces, often with purulent discharge.
The disease is often accompanied by fever, worsening of the patient's general condition and acute pain in the affected arms and legs. Inguinal and femoral lymph nodes become enlarged and painful.
Vesicular (inflammatory) form of mycosis of the feet
The inflammatory form of mycosis of the feet is usually determined by foreign authors, often defining it as acute. It can develop from a chronic mesodactylic form of dermatophytosis.
As a rule, the causative agent of the vesicular form is the dermatophyte Trichophyton rubrum.
Main symptoms: intense itching, skin rashes, localized mainly on the soles, the base and sides of the toes, the back of the foot. Swollen areas with blisters may appear on the surface. Bubbles can merge or remain unchanged for a long time - if the tire (top) is thick enough.
Often the nail plates are also involved in the process - onychomycosis develops.
Ulcerative form of mycosis of the feet
The ulcerative form (in foreign literature it is called deep) is one of the complications of mycosis of the feet, caused by the addition of a bacterial infection.
Extensive deep purulent ulcers form on the soles. The patient experiences severe pain and, as a result, difficulty walking.
Complications of foot fungus
Cracks and ulcers in the skin that appear at the site of the fungal infection are entry points for bacterial infections. However, it is more difficult to treat such infections - this is explained by the fact that fungi produce special substances that increase the resistance of bacteria to drugs.
The most common complications of athlete's foot:
- allergic dermatitis of infectious and medicinal origin.
- pyoderma - pustular skin diseases (cellulitis, lymphangitis, inflammation, osteomyelitis of the bones of the leg), which can lead to deep, long-term skin wounds.
- plantar warts;
- Microbial eczema is a chronic inflammatory disease in which the skin itches and reddens, and blisters with fluid on it.
- general decrease in immunity and weakened microcirculation in the lower extremities (usually develops in patients with diabetes mellitus and varicose veins).
- spread of the disease to the skin of the hands and nails.
- deterioration of the quality of life: in acute forms of mycosis it is difficult to wear shoes, and lymphadenitis leads to fever and poor health.
Diagnosis of foot fungus
A dermatologist-mycologist deals with the diagnosis and treatment of foot fungus.
At the appointment, the doctor will assess the condition of the patient's nails, skin, mucous membranes and hair. He will perform a dermoscopy - examine the skin under magnification. Along with the examination, the specialist will collect memories and ask the patient about his lifestyle, quality of diet, household habits and care procedures.
If you suspect athlete's foot, your doctor will order lab tests.
Examination of skin scrapings will rule out or confirm a fungal infection.
The doctor may also refer the patient for microscopic examination and culture.
Seeding, or the cultural method, allows you to get more accurate information about the causative agent of the disease, although it takes longer - usually a month.
Diabetes mellitus can significantly worsen the course of foot fungus and lead to serious complications. Complex studies can exclude or confirm this diagnosis.
A complete blood count helps to assess the general condition of the patient.
A clinical blood test is a blood test that allows you to assess your general health, detect inflammation, bacterial, viral and fungal infections and can also help diagnose anemia, diseases of the hematopoietic organs, allergic reactions and autoimmune diseases.
Also, before recommending antifungal treatment, the doctor may prescribe the patient a biochemical blood test - this study will determine the level of bilirubin and liver enzymes ALT and AST. Such information will help the doctor choose the dosage of the drug and minimize the risk of side effects.
Treatment of foot fungus
The treatment of foot fungus is carried out in two stages.
In the first stageIf there is acute inflammation, lotions are used: aqueous solutions of ammonium asphalt sulfonate, agents with antiseptic properties (Castellani liquid, 1% aqueous solution of brilliant green). Pastes and ointments containing antifungal and glucocorticosteroid drugs are then prescribed.
In case of intense crying (in the acute phase) and the addition of secondary infection, anti-inflammatory solutions are used as lotions, as well as combined antibacterial drugs in the form of creams and solutions.
The basis of treatment is the use of antifungal - antifungal - agents.
On the main stagetreatment uses antifungal drugs designed to destroy pathogenic fungi. Most often, such drugs are produced in the form of ointments, creams or solutions.
If the patient is bothered by intense itching, the dermatologist can prescribe antihistamines. They are usually taken for 10-15 days, until the unpleasant symptom completely disappears.
When the nails are damaged, antifungal agents are used - they are applied directly to the nail plate and nail folds. In this case, the drug is concentrated on the surface of the nail and does not penetrate into the bloodstream, eliminating the risk of side effects.
If external drugs have no effect, systemic antifungal agents are prescribed.
The treatment regimen and the dosage of the drugs are determined by the doctor. During treatment, it is necessary to visit a podiatrist at least once a month.
Prognosis and prevention
If you consult a doctor in time, the prognosis for foot fungus is favorable: most patients who take antifungal drugs get rid of the disease forever.
To prevent mycosis, you need to protect your feet and hands from irritants and traumatic factors and strengthen your immune system.
Measures to prevent onychomycosis:
- Change socks every day or more often if your feet are sweaty or wet.
- Air or dry shoes after use.
- use an antifungal UV shoe dryer.
- Do not wear common slippers when visiting.
- don't try on shoes in a store with bare feet.
- use a personal towel for your feet.
- use individual tools for nail care (tweezers, files).
- wear shoes in the pool or sauna.
- monitor the diversity of your diet.
- avoid stressful situations.
FAQ
How to treat athlete's foot?
For the treatment of foot fungus, antifungal drugs are usually used, which are available in the form of creams, ointments and solutions. A dermatologist must choose the most effective drug and determine its dosage.
Why do my feet itch?
One of the causes of itchy feet is athlete's foot, an infectious disease caused by a dermatophyte mold.