Epidermophytosis of the feet

Epidermophytosis of the feet. It is a Dermatosis that frequently invades interdigital spaces and the soles of the feet , produced by different genus of dermatophytes.

Epidermophytosis-producing fungal species belong to the genus Epidermophyton Hoccosom or Tricophyton Menfagrophytes , rubrun and rarely Microsporum .

Summary

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  • 1 Clinical Forms
  • 2 Vesicular Type
  • 3 Scaly Type
  • 4 Type Interdigital Macerate
  • 5 Epidermophytosis lesions are almost always symmetrical
  • 6 Differential Diagnosis
  • 7 Dyshidrosis
  • 8 In the case of secondary infected lesions, use of systemic antibiotics such as
  • 9 Prophylactic Measures
  • 10 Sources

Clinical forms

  • Flaky.

Vesicular.

  • Interdigital macerate.

Vesicular Type

A variable number of vesicles irregularly scattered throughout the soles of the feet are presented, which may well take the inner edge of the feet, the Metarcian region to the interdigital spaces. Said intraepidermal vesicles of variable size, from a few millimeters to a few centimeters , are clear, transparent and can be accompanied by intense discharge. A frequent clouding of the contents of the vesicles is frequently observed , which transform into pustules , due to secondary infection. Frequently a reddening of the inflamed region is observed, and sometimes a trace of Lymphangitis is seen from them. In these cases the infection is very painful and prevents walking. The vesicles generally evolve with little inflammation and are discarded without rupture. But sometimes two or more vesicles converge open to the outside and leave a bloody and painful surface.

Flaky Type

It is frequently located on the soles of the feet, extending to the edges and sometimes to the back and toes. The region is covered with more or less abundant whitish scales on erythematous bases. Occasionally it presents with clusters of horny material, especially in the soles of the feet in plates, constituting the hyperkeratotic type and frequently produces some functional impotence.

Interdigital Macerated Type

Settle preferably between the last two pieces and sometimes against all pieces of both feet. Masses of whitish or white-yellowish color, wet, macerated, of adherent soft consistency are observed that selectively occupy the bottom of the interdigital groove and frequently extend on both lateral faces of the knuckles. This whitish surface covers an erythematous base, although in some cases only a fissure and crust is observed at the bottom of the interdigital space. Intense itching usually accompanies this clinical form .

It should be noted that these clinical forms do not always appear as such, but rather mixed with each other, forming mixed clinical pictures.

Epidermophytosis lesions are almost always symmetrical

They can give rise to manifestations at a distance, especially on the hands , of the vesicular or eczematoid type in itchy segregating plaques. In these lesions the fungus is not found and they are interpreted as allergic manifestations and it is described with the name of Epidermophytides or simply Phytids.

It is the most frequent superficial mycosis in Cuba. It affects both sexes equally, especially adults, children are less affected.

It has a high degree of contagiousness, but it is transmitted through indirect means (the use of common footwear, wandering barefoot through contaminated gyms and toilets and as a predisposing factor the non-hygiene practiced daily such as: bathing, changing stockings, etc; use of footwear humid or very closed.

Differential Diagnosis

  1. Candidiasis of the feet:These are marked lesions that take up all the interdigital spaces. These lesions are wet, exudative, with large painful cracks, and the center of the lesion appears whitish and the edges are sometimes crowned by pustular lesions .
  2. Secondary Syphilis:The lesions are located on the soles of the feet that are not itchy or painful.
  3. Dermatitis Contact: Theydraw the control with the stocking or footwear that produced the condition.
  4. Psoriasis:They are generally more scaly lesions, lesions may appear on the palm of the hands or other site of appearance of Psoriasis such as elbows, knees, etc.

Dyshidrosis

Treatment: In acute forms ( Vesicular and Pustular ) it is recommended: a) Rest in bed.

  1. b) Wet cures with promotions of Potassium Permanganate 1×40000 1% or Acriflavin 1/5000.
  2. c) Development with Caña Santa .

The pustular manifestations observed in the feet may be due to secondary staphylococcal infections and in some cases in these pustular lesions they appear to be sterile, Andrews interprets them as allergic manifestations at a distance from a pyogenic infectious focus (tonsils, teeth, etc.) calling them bacterial .

In the case of secondary infected lesions, use of systemic antibiotics such as

  1. Erythromycin
  2. Chloramphenicol
  3. Cephamexin

Do not use Penicillin as it is of a fungal nature.

Do not use Tetracycline in children under 12 years, effective in children over 12 years.

Prophylactic measures

  1. No use of closed footwear.
  2. No use of borrowed shoes.
  3. Dry your feet well after bathing.
  4. Take your shoes out in the sun.
  5. Use of ventilated sandals.
  6. Use of wooden flip flops or racks in collective bathrooms.
  7. Use prophylactic antifungal powder in the morning and after the bath.

 

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