Tinea Pedis: Characteristics, Diagnosis, Treatment and Prevention

Thousands of infections and injuries are taking place in our daily life due to our carelessness. Several infections/ blisters first appear and gradually convert into a big and painful disease. It’s always recommended to visit a doctor at least once a month or urgently if a person found something unusual in his/her body (Auger 1992: 23). Tinea Pedis is a fungal infection that usually occurs at the feet. It needs special care and attention and proper medicine to get rid of it in a short time. People usually suffer a lot from it when they ignore it at its early stages. Tinea Pedis causes due to a dermatophyte fungus (Brooks & Bender 1996: 23). Tinea Pedis booms in warm wet situations and it is one of the most common diseases or infections in young adult men.

Tinea Pedis mostly occur due to the following three causes:

  • Trichophyton (T.) rubrum
  • T. interdigitale previously called T. mentagrophytes var. interdigitale
  • Epidermophyton floccosum

Tinea Pedis has several forms and can impress one or both feet. Chronic hyperkeratotic tinea usually points to uneven smooth dry scaling on the sole of the toe. Moccasin’ tinea is commonly referred to as extensive hyperkeratotic tinea, in this infection, the skin of the entire sole, heel and sides of the foot starts being drying but at early stages, they are not inflamed. The impressive portion does not admit the upper part of the foot. The basic cause of such a situation is T. rubrum. Athletes’ feet are usually seen as moist peeling irritable skin between the feet, usually found in the clings between the fourth and fifth toes. Clusters of blisters are usually found in between the third to fifth toes.

Tinea Pedis is an infectious disease as other people can get affected by it. Tinea Pedis is growing very fast and daily thousands of people are affected by it due to carelessness (Clayton, 1992: 12). This is an infection that can be dealt with easily with proper care and precautions. Following are some characteristics of Tinea Pedis.

  • Tinea Pedis are usually displayed to the spores’ at various places even at home.
  • Tinea Pedis usually excretes less fatty acid that is commonly known as the antifungal agent).
  • People with Tinea Pedis usually wear plosive footwear.
  • It is always recommended to those who suffer from Tinea Pedis to wear a pair of socks when they go out.
  • People with Tinea Pedis sweat excessively (hyperhidrosis).
  • Due to medicine and creams they lack azathioprine and they become more likely for germal attacks.
  • People with Tinea Pedis usually posses’ bad blood circulations in cold feet because of lymphoedema.

Tinea Pedis is usually diagnosed with the help of microscopy or culture of skin scrapings. Several other causes resist in proper treatment of Tinea Pedis.

Case Study

A patient visited a medical clinic for his check-up. He was suffering from vesicular rash on the soles of his feet. The clinician suspected Tinea Pedis. The clinician wanted to collect the data for further investigation and proper diagnosis. The clinician called the laboratory in order to get the advice or to inquire about the procedure of collecting suitable specimens of Tinea Pedis. He got the response from the laboratory that athlete’s foot is very common and can be flexibly handled, Tinea Pedis could be painful and it can easily banquet to the foot nails, and it can also give rise to severe bacterial infection of blisters and painful cracks that can also develop on the affected area. The laboratory man told him that it should be handled properly as it can be transferred to another person belonging to that patient. The laboratory man advised him to collect the small portion of infectious skin to get a detailed examination with the help of microscopes. Most of Tinea Pedis is unrecognized and untreatable. According to one estimate every individual faces this infection at least once in a life (Heikkila 1995: 12). Hew also got the advice to do little scrapings of scale properly cleaned with alcohol, Skin stripped off with adhesive bandage, take the sample of hair which has been attracted out from the roots, little part of the scaly scalp, a small portion of Nail clippings. Skin biopsy is also one of the best options for collecting the specimen of Tinea Pedis. The laboratory men told him that the specimen should not be delayed and should reach the laboratory as soon as possible (Larone 1996: 21). He advised more that it is better to send the patient to the laboratory for proper examination if not possible than refer the nurse to collect/ submit the specimen (Rebell 1970: 23). The proper way of collecting the skin specimen is based on three steps:

  • Clean the affected area with ethanol.
  • The margin of the tension for further operation.
  • Wrap the strapping material in paper and send it to the laboratory.

In response to his question about results, the laboratory man told him that results can be inquired after 48 hours. Laboratory tests usually take 12-48 hours to issue the report.

There are 4 clinical presentations of Tinea Pedis which are as follows:

  1. Interdigital
  2. Chronic hyperkeratotic
  3. Inflammatory/vesicular
  4. Ulcerative

Interdigital

This is the most common type of Tinea Pedis. This is a complex type of disease and it is usually referred to as dermatophytosis complex (Sais 1995: 43).

Chronic hyperkeratotic

In this type, both feet are affected and in severe cases infection extends onto the both sides.

Inflammatory/vesicular

It is the most painful presentation of Tinea Pedis, they contain a purulent fluid.

Ulcerative

Cellulitis, lymphangitis, pyrexia, and malaise can appear in this infectious situation.

Examination

There are two main methods of examining the fungal specimen of Tinea Pedis

  1. Direct Microscopy
  2. Culture

Direct microscopy

The material is usually analyzed by microscopy by adopting one or more of the following methods (Weitzman 1995: 23):

  • Potassium hydroxide (KOH) preparation, stained with blue or black ink
  • Stainless wet-mount
  • Stained dried blot
  • Histopathology of the diagnostic assay with special stains.

Microscopy can be recognized a dermatophyte with the aid of

  • Fungal hyphae for building up a mycelium
  • Arthrospores i.e. broken-off spores
  • Arthroconidia
  • Inside and outside hair spores.

Fungal elements are really hard to find, recognized exclusively if the tissue is very ablaze, so an unfavorable outcome does not govern out fungal infection.

A yeast infection can be recognized in the presence of:

  • Yeast cells, which help in division by budding.
  • Pseudohyphae

Culture

Culture recognizes which species is responsible for the infection. Culture is usually done in order to find out the cause /reason of this infection (Laboratory tests for fungal infection, 2008 : 1).

The main objective of culture is listed below:

  • To figure out the cause of infection, for instance, a specific animal
  • To point out the best suitable medicine or treatment.

Growth of the fungus in culture usually takes a number of weeks, brooded at 25-30ºC. The specimen is immunized into a medium like Sabouraud’s dextrose agar which contains cycloheximide and chloramphenicol. The cycloheximide is left out if a mold needs recognition.

Several causes give rise to negative culture:

  • The situation is not due to fungal contagion.
  • The specimen was not collected and examined efficiently.
  • Antifungal treatment had been used before to the accumulation of the specimen.
  • There was a major delay in specimen arrival at the laboratory.
  • The laboratory procedures were not appropriate.
  • The organism develops very slowly.

Treatment of Tinea Pedis can help in recovering from this disease however, people suffering from Tinea Pedia need special care and attention (Tenia Pedis – TINEA OF FEET AND HANDS, 2008: 1). By taking two preventive measures a person can be saved from Tinea Pedis. By keeping feet dry as much as possible. Always try to wear open-toed sandals as open-toed sandals help a lot in keeping your feet exposed to air. Closed-toed sandals do not give free access to air, avoid closed high-heeled boots, always dry carefully your feet after washing. By taking these measures one can easily protect his feet from Tinea Pedis (Sais 1995: 45). Using quality foot powder is also considered as one of the best precautions in this vein (Topical antifungal drugs in the treatment of Tinea Pedis, tinea cruris, and tinea corporis, 1993: 21).

I would respond to the doctor’s inquiry came as the laboratory man did. The Laboratory man provided the best answer to the doctor’s inquiry. I would also add the first aid technique or medicine in order to provide relief to the patient before examining fungal disease which the laboratory man missed. Tinea Pedis is very common and can be controlled easily but proper need and treatment are required.

Conclusion

Tinea Pedis is uncommon and common fungal infection at the same time. There are several causes of fungal infection but it can be prevented by taking some precautionary steps. The patient visited the clinic and the Clinician recognized that he was suffering from Tinea Pedis than he called the laboratory in order to investigate collecting the fungal specimen for further examination and he was also intended to know the best transport for sending the specimen sample to the laboratory. The clinician’s queries were completely answered by the laboratory man. Tinea Pedis patient needs special care/ proper treatment and proper medicine to resist severe Tinea Pedis. Tinea Pedis can be caused by different factors and all factors are equally important to be considered at early stages. I would also respond the same to doctor’s inquiry. Any disease is needed to be dealt with care to prevent severe skin damage. Tinea Pedis can also be controlled by taking some precautionary measures like open-toed sandals, use of foot powder etc. Treatment of Tinea is not very difficult but it should be in an effective manner.

List of References

  1. Auger P, (1992), “Epidemiology of tinea pedis in marathon runners”, Prevalence of occult athlete’s foot. Mycoses.;36:35–41.
  2. Brooks, Bender, (1996), Tinea Pedis: diagnosis and treatment. Clin Podiatr Med Surg, ;13:31–46.
  3. Clayton, (1992), Clinical and mycological diagnostic aspects of onychomycoses and dermatomycoses. Clin Exp Dermatol.;17:37–40.
  4. Heikkila,(1995), The prevalence of onychomycosis in Finland. Br J Dermatol, 133: 699–703.
  5. Larone(1996), Culture and identification of dermatophytes. Clin Microbiol Newsl, 18:33–38.
  6. Rebell G,(1970), The dermatophytes. Their recognition and identification. Coral Gables: University of Miami Press.
  7. Sais G (1995), Prevalence of dermatophyte onychomycosis in Spain: a cross-sectional study. Br J Dermatol.;132:758–761.
  8. Weitzman I, (1995), The dermatophytes. Clin Microbiol Rev.;8:240–259.
  9. Laboratory tests for fungal infection, (2008), Laboratory tests for fungal infection.
  10. Tenia Pedis – TINEA OF FEET AND HANDS, (2008), Tenia Pedis – TINEA OF FEET AND HANDS.
  11. Sais G,(1995),. Prevalence of dermatophyte onychomycosis in Spain: a cross-sectional study. Br J Dermatol. 132:758–761.
  12. Topical antifungal drugs in the treatment of Tinea Pedis, tinea cruris, and tinea corporis, (1993), Topical antifungal drugs in the treatment of Tinea Pedis, tinea cruris, and tinea corporis.