Foot Fungus (Athlete’s Foot): Clinical Overview & Management

Pathogenesis

Foot fungus, medically termed Tinea pedis, is a dermatophytic infection thriving in warm, moist environments. Summer exacerbates risk factors due to hyperhidrosis (excessive sweating) creating optimal fungal growth conditions.

Classification by Lesion Morphology

1. Vesicular Type
   • Presentation: Fluid-filled blisters, erythematous base
   • Common sites: Arch and instep regions
2. Scaly Type
   • Presentation: Dry, flaky plaques with peripheral scaling
   • Common sites: Plantar surfaces and lateral borders
3. Macerated Type
   • Presentation: White, sodden skin with fissures
   • Common sites: Interdigital spaces (esp. 4th-5th toes)

Therapeutic Protocol

Systemic Therapy

• Saltopiran® (Itraconazole 100mg/capsule)
  • Dosage: 2 capsules (0.2g) PO once daily × 14 days
  • Mechanism: Azole antifungal inhibiting ergosterol synthesis

Topical Therapy

• Compound Salicylic Acid 3% + Terbinafine 1% Cream
  • Application: BID × 28 days
  • Key actions:
    • Salicylic acid: Keratolytic debridement
    • Terbinafine: Fungicidal allylamine

Critical Note: Continue therapy ≥7 days post-symptom resolution to prevent recurrence.

Infection Control Measures

1. Footwear Management
   • Discard contaminated shoes/socks
   • Use breathable footwear (leather/canvas > synthetics)
2. Hygiene Protocol
   • Daily foot washing with pH-balanced soap
   • Complete drying (blotting > rubbing, focus on interdigital zones)
3. Environmental Decontamination
   • Disinfect floors/showers with 10% bleach solution

Prognosis: >90% clearance rate with protocol adherence. Immunocompromised patients require extended surveillance.