Epidermophytia of the feet is one of the most common diseases, which is characterized by mycotic lesions of the skin and nail plate of the feet. The disease can manifest itself in the form of spots and flat papules with peeling of a whitish hue on the surface, red plaques, bubbles, erosions, cracks, the appearance of spots and stripes on yellow nails, rejection or thickening of the nail plate in accordance with the clinical form. The diagnosis of epidermophytosis of the feet includes luminescent diagnostics, dermatoscopy, determination of the hydrogen index of the skin, microscopy of scraping for pathogens of mycotic diseases, detection of parallel diseases of the feet. Treatment of fungal foot disease consists of the use of systemic and local antimycotic agents with preliminary anti-inflammatory or exfoliating therapy.
Epidermophytia of the foot is a fungal disease that is often found all over the world. According to some estimates, almost 10% of people around the globe suffer from this disease. Up to 80% of patients are representatives of different professional categories: athletes, miners, workers of baths and hot shops. Cases of foot epidermophytosis occur mainly among adults, and more often in the urban population than in rural.
The content of the article:
Causes of epidermophytosis of the feet
Symptoms of epidermophytosis of the feet
Squamous epidermophytia
Intertriginous epidermophytia
Dyshydrotic epidermophytia
Erased epidermophytia
Epidermophytia of the nail plate
Diagnosis of epidermophytosis of the feet
Treatment of epidermophytosis of the feet
Epidermophytia of the feet
Causes of epidermophytosis of the feet
There is an epidermophytia of the feet due to infection with the pathogen Trichophyton mentagrophytes, which can also provoke diseases such as epidermophytia of the inguinal region and epidermophytia of the nails. Healthy people can become infected with the fungus from patients by contact in gyms, showers, public saunas, baths and swimming pools through common use items. Mycelium and fungal spores are present in scales detached from the stratum corneum of the skin, which the patient often loses during epidermophytosis of the feet. The fungus, which thus got on the mats in shower stalls, rugs, washcloths and shoe insoles, is able to persist there for a long time, especially if the environment is warm and humid.
Not all people infected with the fungus Trichophyton mentagrophytes can get foot epidermophytosis. Favorable conditions for the disease are trophic disorders of the legs, which can manifest themselves in varicose veins with chronic venous insufficiency, diabetes mellitus, deep thrombosis of peripheral vessels, atherosclerosis, polyneuropathy, vegetative vascular dysfunction. Increased sweating of the feet, an alkaline reaction of sweat, narrow spaces between the fingers, flat feet can contribute to the occurrence of a fungal disease.
Symptoms of epidermophytosis of the feet
Modern clinical dermatology differentiates five types of fungal foot disease: intertriginous, squamous, erased, dyshydrotic and epidermophytia of the nail plate. These forms of the disease can pass from one to another or combine with each other. Separately, dermatology distinguishes the so—called epidermophytides – allergic rashes that manifest themselves due to the sensitization of the body to the antigens of the causative agent of the disease (fungus Trichophyton mentagrophytes).
Squamous epidermophytia
Squamous epidermophytia of the feet manifests itself in the form of red plaques with grayish-white peeling or flat papules that appear on the skin of the arch or on the sides of the foot. Lesions may resemble plaques typical of psoriasis and have clear boundaries. There is a border around the circumference of the plaques, consisting of peeling skin with single small bubbles. Peeling is often combined with the phenomena of plantar hyperkeratosis in the form of cracks and yellow-tinged corns on the surface, which resemble manifestations of mechanical dermatitis. Fickle and moderate itchy sensations are characteristic.
Intertriginous epidermophytia
Intertriginous epidermophytia of the feet often affects the skin between the middle and ring finger or between the little finger and ring finger, can spread to the surface of their folds. The disease manifests itself as foci of puffiness, redness and wetness of the skin, maceration, the appearance of erosions and cracks. Patients note itchy and painful sensations in the lesions, with the formation of erosions.
Dyshydrotic epidermophytia
Dyshidrotic epidermophytosis of the feet manifests itself in the form of small rashes of bubbles on the skin. Most often they are located on the arches of the feet, at the same time the skin of the soles, the folds between the fingers and the fingers themselves can be affected. Having previously increased, the bubbles merge and form multi-chamber formations, after which erosive elements of a pink-red hue form on the skin. Patients report itching and painful sensations. With a pronounced inflammatory element, edema and skin redness occur, which resemble dyshydrotic eczema in clinical manifestations.
Erased epidermophytia
Erased epidermophytia of the feet is hardly noticeable, its symptoms are small cracks or peeling foci that are located in the interdigital spaces.
Epidermophytia of the nail plate
Epidermophytia of the nail plate is manifested by thickening, brittleness, rejection of the nail and its yellowness. The thumb and little finger are more often affected.
Wetness, cracks and erosion of the skin, which often occur with epidermophytia of the feet, contribute to infection of the skin with streptococcal bacteria, infection with the development of erysipelas, streptoderma, phlebitis, thrombophlebitis, lymphadenitis or lymphangitis.
Diagnosis of epidermophytosis of the feet
Diagnosis of the disease is carried out by a dermatologist or a specialist in the field of mycology. As a rule, the diagnosis consists in conducting a luminescent examination, determining the pH balance of the skin and examining the lesions with the help of dermatoscopic examination. Scraping from the affected nail and skin is studied under a microscope to identify fungal spores and mycelium filaments, which must be distinguished from the loop-like or mesh structures of a mosaic fungus, which is a product of the breakdown of cholesterol in the skin.
Examination under a microscope will not reveal which kind of fungus has become the causative agent of the disease. For the differential diagnosis of the fungus Trichophyton mentagrophytes from other pathogens of fungal diseases (rubromycosis, trichophytia, pityriasis, candidiasis, coccidiomycosis), scraping is also carried out on nutrient media.
When diagnosing parallel diseases, additional examination by specialists such as an orthopedist, podologist, vascular surgeon, endocrinologist or phlebologist may be required.
Treatment of epidermophytosis of the feet
Treatment of fungal foot disease is two-stage. At the initial stage, with the squamous form of epidermophytosis of the feet, hyperkeratic layers and scales are removed, with the dyshidrotic and intergriginous form, the acute inflammatory process is removed. In the first case, preparations with keratolytic action (salicylic acid and lactic acid, baths with soap and soda solution for the feet) are used in the treatment of epidermophytia of the foot, in the second case — the use of antihistamines and anti-inflammatory drugs). With epidermophytosis of the nails, the nail affected by the fungus is surgically removed.
The main stage of treatment of the disease consists in the treatment of fungal areas of the skin and / or the removed nail bed with drugs with antimycotic effects (Castellani liquid, “Mycoseptin”, nitrofungin, ointments “Mycozolon”). If the course of epidermophytosis of the feet is prolonged, stubbornly untreated, accompanied by damage to the nail plate, specialists prescribe systemic therapy with antifungal agents to patients: diflucan, orungal, nizoral, lamizil, etc.
