Foot fungus
The content of the article:
- Causes of foot fungus and risk factors for its development
- Forms of the disease
- Foot fungus symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention of foot fungus
Foot fungus is the collective name adopted in everyday life for a group of superficial skin diseases provoked by various types of fungi that affect the skin and nail plates of the feet.
Peeling is one of the signs of a foot fungus
The fungus of the foot everywhere occupies a leading position in the structure of fungal infections (mycoses) of the skin. According to some data, the disease is recorded in 15–20% of the population (some authors indicate that a third of the world's inhabitants suffer from foot fungus).
A number of studies demonstrate a doubling of cases of detecting foot fungus every 10 years, in terms of the rate of increase in the incidence and frequency of occurrence, this pathology is very close to respiratory (colds) diseases. The lowest prevalence of the disease is noted in Sweden, Great Britain and Spain, although in most European countries, foot fungus is recorded in every third patient who consults a dermatologist (according to the Achilles project, carried out from 1988 to 1997).
When assessing gender and age differences, a more frequent susceptibility to foot fungus in men (1.5–3 times), predominance among patients of older people, the elderly (in the Russian Federation - in every second patient over the age of 70) was unambiguously revealed.
The increase in the number of people with foot fungus is due to several reasons:
- intensive migration processes;
- an increase in the number of autoimmune, allergic diseases and immunodeficiency conditions, which significantly affect the body's resistance to the effects of infectious agents;
- deterioration of epidemiological control;
- insufficient socio-economic level in some cases; etc.
Synonym: mycosis of the feet, athlete's foot, rubromycosis.
Causes of foot fungus and risk factors for its development
The main cause of fungal infections of the skin and nail plates of the foot is infection with dermatophyte fungi of the genera Epidermophyton and Trichophyton:
- red trichophyton (Trichophyton rubrum) - from 70 to 90% of all cases;
- interdigital trichophyton (Trichophyton interdigitale) - 10-30% of fungal lesions of the foot;
- epidermophyton inguinal (Epidermophyton floccosum) - the most rare pathogen, causes 1-1.5% of cases.
Mostly foot fungus is associated with infection with dermatophytic fungi of the genera Epidermophyton and Trichophyton
The characteristic features of these fungi contribute to the intensive spread of dermatophytes:
- the ability to produce proteolytic enzymes (keratinases) that facilitate the penetration of pathogens through the epidermal barrier;
- the ability to assimilate the destroyed protein keratin, which forms, along with collagen and elastin, the outer waterproof layer of the skin and nail plates.
The pathogens that provoke the development of foot fungus are transmitted by direct contact of spores with the unchanged skin of a healthy person, primarily affecting smooth skin, secondarily, nail plates. The optimal conditions for the existence of pathogenic fungi outside the host's organism are a neutral (possibly slightly acidic or slightly alkaline) environment, temperatures from 20-25 to 36-37 ºС, high humidity.
In the case of the spread of the foot fungus from smooth skin to the nail plate, there are two possible ways of infection penetration (cross-infection through the thickness of the nail in this case practically does not occur):
- from the free edge of the nail (the most frequent route of penetration), the inflammatory process in this case does not unfold in the plate itself, but in the soft tissues of the subungual bed;
- from the side of the nail roller at the point of contact of the nail plate with the skin.
Infection with pathogenic fungi is possible in several cases:
- long-term stay in places of high crowding of people in a limited area (service in the ranks of the armed forces, training bases, boarding schools, etc.);
- visiting common areas without shoes (sauna, swimming pool, gym locker room, etc.);
- wearing common shoes;
- illness of any family member living together.
Despite the ubiquitous prevalence of foot fungus, even close relatives who use a shared living space may not have the disease in some family members while others have it. The likelihood of infection with pathogenic fungi is not the same, has individual characteristics and depends on the presence of certain risk factors:
- immunodeficiency states;
- the presence of chronic diseases in which local blood flow suffers (for example, diabetes mellitus, chronic venous insufficiency of the lower extremities, etc.);
- wearing tight shoes or shoes made of unnatural materials (inadequate ventilation and high humidity create optimal conditions for the development of foot fungus);
- microtrauma of the skin and nails;
- close systematic contact with water, synthetic fabrics, harsh chemicals that reduce local protection;
- increased sweating;
- anatomical features that impede the access of oxygen to the tissues of the foot (narrow interdigital spaces, flat feet, etc.);
- old age (age-related disorders of trophic processes);
- slow regrowth of the nail plate (the lower the rate of nail growth, the more aggressive the pathological process).
Forms of the disease
Depending on the type of pathogen, the disease can occur in the form of rubrophytosis or epidermophytosis. Despite the different etiological factors, the signs of a foot fungus are similar in both cases.
Types of foot fungus classified on the basis of clinical manifestations:
- erased form;
- squamous;
- hyperkeratotic;
- intertriginous (interdigital);
- dyshidrotic.
Foot fungus symptoms
Despite some differences characteristic of certain types of foot fungus, a number of common manifestations can be distinguished:
- itching, burning on the plantar surface and in the interdigital spaces of the foot;
- peeling with separation of whitish scales;
- cracking of the skin, often in the area of the fingers, heels;
- clouding and discoloration of nails, brittleness, detachment from the subungual bed;
- hyperemia of the skin in the focus of inflammation;
- unpleasant odor;
- increased sweating;
- hyperesthesia (increased sensitivity) of the plantar surface.
In some cases, foot fungus is asymptomatic for a long time, patients are only worried about an unpleasant odor and increased sweating or slight peeling.
Foot fungus primarily affects the interdigital spaces
In addition to similar features, specific manifestations of the foot fungus are characteristic of various clinical forms.
A feature of the erased form of the foot fungus is the absence of obvious complaints, there are objectively minor cracking, hyperemia of the skin, more often in the interdigital spaces, minor flaking.
Symptoms of the squamous form of the foot fungus (classic manifestations of rubrophytosis of the feet):
- massive peeling in the area of the fingers and lateral surfaces of the feet;
- the skin pattern is strengthened and thickened;
- hyperemia is possible;
- lack of active complaints, sometimes itching, which does not affect the quality of life, worries.
Manifestations of the hyperkeratotic form:
- multiple noncavity flat elements, nodules (papules) on the skin surface, localized more often in the arch of the foot;
- purple-red, cyanotic plaques with enhanced skin pattern;
- the central part of the rash is covered with layers of skin scales, along the periphery there is a border with exfoliating epidermis;
- single vesicles between peeling foci;
- hyperemia, dry skin.
The intertriginous form of the foot fungus is manifested by the following symptoms:
- clearly contoured, intensely hyperemic foci in the interdigital spaces;
- swelling of the skin at the site of inflammation;
- weeping, maceration (swelling and softening) of the skin;
- along the periphery of hyperemic areas - whitish fringed peeling epithelium;
- intense itching, in some cases - soreness.
Symptoms of a dyshidrotic foot fungus:
- eruptions in the form of blisters (mainly on the arch of the foot), prone to fusion and filled with transparent serous contents;
- when the bubble is opened, a bright eroded surface is exposed;
- intense hyperemia in the focus of inflammation.
The disease in the vast majority of cases has a chronic course with episodes of exacerbations provoked by the influence of aggressive environmental factors and remissions. For young people, a wet version of the fungus of the foot is more characteristic, while in older patients, inflammation with foci of peeling is more often diagnosed.
Diagnostics
In order to diagnose foot fungus, the following laboratory tests are performed:
- microscopic examination of the material obtained from the surface of foci of peeling or wetting, under a light microscope;
- sowing the resulting material on a nutrient medium in order to determine the species of the pathogen;
- polymerase chain reaction (determination of DNA fragments of pathogenic fungi).
To diagnose foot fungus, a microscopic examination of the material from the surface of the lesions is carried out
Treatment
Treatment of foot fungus is carried out in stages. Initially, acute inflammation is stopped if it is present - lotions, foot baths, powders, etc., and excessive layers of keratinized skin are removed with the help of keratolytic drugs.
Further treatment is carried out with creams, which are a combination of local antifungal drugs, corticosteroid hormones and antibiotics. When the manifestations of an acute inflammatory process are eliminated, medicinal creams are replaced with ointments (they have a more oily texture), sprays, gels.
In addition to local treatment, oral administration of an antifungal drug is prescribed. Antimycotic drugs most commonly used in the treatment of foot fungus:
- azole compounds, triazoles (Itraconazole and Fluconazole);
- an allylamine derivative, Terbinafine (is the drug of choice for foot fungus).
Antimycotic agents are prescribed for the treatment of foot fungus
For the most effective treatment and speedy recovery, in parallel with taking medications, you must follow some recommendations:
- refuse to wear shoes made of synthetic materials;
- change shoes or rinse thoroughly and treat it from the inside with special antifungal agents;
- iron socks, tights after washing with steam from the inside or change to new ones.
In severe cases, along with antimycotic drugs, immunomodulators, adaptogens and antioxidants, vitamins of groups A and E, antihistamines are prescribed, and detoxification therapy is carried out.
Possible complications and consequences
Complications of the foot fungus can be:
- development of combined (multiple) sensitization, increased allergic readiness;
- secondary infection of damaged skin, up to the development of sepsis in severe cases;
- the formation of plantar warts;
- onychomycosis.
Forecast
With complex treatment, adherence to personal hygiene measures and strict implementation of all recommendations for the duration of treatment, the prognosis is favorable.
Prevention of foot fungus
The main preventive measures that can prevent the development of foot fungus:
- wearing rubber shoes that can be disinfected when using a shared bathroom, shower, bath, etc.;
- avoiding the use of common shoes in public places (for example, non-disposable slippers in hotels);
- availability of individual home and outdoor footwear and hosiery for all family members;
- daily foot washing;
- daily change of hosiery.
YouTube video related to the article:
Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
