table of contents
◼️ Definition
A contagious fungal infection (dermatophytosis) affecting the feet, characterized by epidermal invasion of keratinized tissues.
◼️ Clinical Subtypes
- Moist/Macerated Form
- Interdigital erythema, fissuring, and malodor.
- Vesicular Form
- Pruritic blisters/vesicles on soles/arches.
- Verrucous Plaque Form
- Thickened, wart-like hyperkeratotic lesions.
- Hyperkeratotic Form
- Scaly, dry plaques on heels/plantar surfaces.
◼️ Predisposing Factors
| Category | Triggers |
|---|---|
| Host Factors | Immunocompromised states, excessive sweating (hyperhidrosis) |
| Environmental | Prolonged moisture exposure, occlusive footwear, shared fomites (towels, bathmats) |
◼️ Affected Anatomic Sites
- Interdigital spaces (esp. 4th-5th toes)
- Plantar surfaces
- Heel regions
◼️ Therapeutic Approach
Topical Agents
- Azole Derivatives: Ciclopirox 1% ointment (bid application × 4 weeks)
- Non-steroidal Anti-inflammatory: Diclofenac gel (adjunct for inflammation)
Systemic Therapy
- Severe/Refractory Cases: Itraconazole 200 mg PO daily × 7-14 days
- Monitoring: Hepatic function tests recommended during oral therapy
◼️ Preventive Strategies
- Footwear: Breathable shoes, moisture-wicking cotton socks
- Hygiene: Daily foot drying, antifungal powders for high-risk individuals
- Contagion Control: Avoid shared personal items; disinfect footwear regularly
Prognosis: Resolution typically occurs within 2-4 weeks with adherence to antifungal regimens. Recurrence rates: 40-60% without preventive measures.