Tinea pedis or athlete’s foot

This is the most common form of tinea in temperate climates (Clayton, 2000). It occurs more often in males than females but rarely before puberty. The responsible fungi are all anthrophilic with T. rubrum the commonest species. It usually starts in the toe spaces, often between the 4th and 5th toe with peeling, white skin and fissures which are usually itchy. It can spread to the toes and soles of the feet. T. rubrum usually results in fine dry scaling on the toes which can become more widespread and chronic. T. interdigitales results in small clear vesicles which can spread onto the dorsum of the foot before they rupture and dry with a scaly edge.

Diagnosis
Scrapings can be taken for microscopy.

Management

1. These lesions respond well to topical antifungals, for example imidazole creams, Clotrimazole twice daily for 2–4 weeks or Terbinafine twice daily for 7–10 days, which is said to be most effective (Crawford and Hollis, 2007).
2. Particularly in tinea pedis, patients should be educated about the importance of good foot hygiene and careful drying, especially between the toes because moisture encourages fungal growth. Patients should also be advised to change socks and shoes frequently if they become moist with cotton socks and natural fibre shoes providing better ventilation. The wearing of flip flops in communal showering facilities or locker rooms should also be advised.
3. It is particularly important to treat tinea pedis in those who are prone to cellulitis.