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Clinical Classification
Athlete’s foot (tinea pedis) manifests in four primary clinical forms:
- Sweat Rash Type: Characterized by erythema and vesicular eruptions.
- Interdigital Type: Presents with maceration, fissuring, and scaling between toes.
- Cornified Type: Features hyperkeratosis, peeling, and lichenification of the plantar surface.
- Moist Maceration Type: Exhibits exudative, sodden skin with potential secondary bacterial infection.
Therapeutic Strategies for Cornified-Type Athlete’s Foot
Topical Antifungal Therapy
- Traditional Chinese Medicine (TCM) Combinations:
- Zanthoxylum piperitum decoction: Reduces inflammation and inhibits fungal growth.
- Kunzea pomifera cream: Enhances skin barrier repair.
- Xiao Er Ointment: Alleviates pruritus and desquamation.
- Salicylic Acid Solutions (2–5%): Promote keratolysis and enhance penetration of antifungals.
Systemic Antifungal Therapy
Indicated for refractory or extensive infections:
- Itraconazole: 200 mg daily for 2–4 weeks.
- Fluconazole: 150–300 mg weekly for 4–6 weeks.
- Terbinafine: 250 mg daily for 2–6 weeks.
Key Considerations
- Combination Therapy: Topical + systemic regimens improve efficacy in hyperkeratotic lesions.
- Adjunctive Measures: Foot hygiene, moisture control, and avoidance of occlusive footwear.
- Monitoring: Assess for treatment resistance or recurrence; consider fungal culture for recalcitrant cases.
Note: Treatment duration and regimen should be tailored to individual patient response and severity. Consult clinical guidelines for updates.