GeneHealth - Your precision medicine

Tinea Pedis

Disease Details

Family Health Simplified

Buy Membership

Description: Tinea pedis, also known as athlete's foot, is a fungal infection that typically affects the skin between the toes, leading to itching, scaling, and redness.
Type: Tinea pedis, commonly known as athlete's foot, is a fungal infection (type) caused by dermatophytes. It is not a genetically transmitted condition; rather, it is acquired through contact with contaminated surfaces or infected individuals.
Signs And Symptoms: Athlete's foot is divided into four categories or presentations: chronic interdigital, plantar (chronic scaly; aka "moccasin foot"), acute ulcerative, and vesiculobullous. "Interdigital" means between the toes. "Plantar" here refers to the sole of the foot. The ulcerative condition includes macerated lesions with scaly borders. Maceration is the softening and breaking down of skin due to extensive exposure to moisture. A vesiculobullous disease is a type of mucocutaneous disease characterized by vesicles and bullae (blisters). Both vesicles and bullae are fluid-filled lesions, and they are distinguished by size (vesicles being less than 5–10 mm and bulla being larger than 5–10 mm, depending upon what definition is used).Athlete's foot occurs most often between the toes (interdigital), with the space between the fourth and fifth digits (the little toe and the fore toe) most commonly affected. Cases of interdigital athlete's foot caused by Trichophyton rubrum may be symptomless, it may itch, or the skin between the toes may appear red or ulcerative (scaly, flaky, with soft and white if skin has been kept wet), with or without itching. An acute ulcerative variant of interdigital athlete's foot caused by T. mentagrophytes is characterized by pain, maceration of the skin, erosions and fissuring of the skin, crusting, and an odor due to secondary bacterial infection.Plantar athlete's foot (moccasin foot) is also caused by T. rubrum which typically causes asymptomatic, slightly erythematous plaques (areas of redness of the skin) to form on the plantar surface (sole) of the foot that are often covered by fine, powdery hyperkeratotic scales.The vesiculobullous type of athlete's foot is less common and is usually caused by T. mentagrophytes and is characterized by a sudden outbreak of itchy blisters and vesicles on an erythematous base, usually appearing on the sole of the foot. This subtype of athlete's foot is often complicated by secondary bacterial infection by Streptococcus pyogenes or Staphylococcus aureus.
Prognosis: Tinea pedis, commonly known as athlete's foot, has a generally good prognosis with appropriate treatment. It is typically treated with antifungal medications, either topical or oral, and maintaining proper foot hygiene. Most cases resolve with treatment, but it can recur if preventive measures are not followed. Early treatment is crucial to avoid complications such as secondary bacterial infections.
Onset: The onset of tinea pedis (athlete's foot) typically involves the gradual development of symptoms such as itching, burning, and stinging between the toes. These symptoms can progress over days to weeks and may be accompanied by peeling, cracking, and redness of the skin.
Prevalence: The prevalence of tinea pedis, commonly known as athlete's foot, can vary widely depending on the population and region. It generally affects 15-25% of people at some point in their lives, with higher prevalence in athletes, military personnel, and individuals who frequently use communal showers or pools.
Epidemiology: Globally, fungal infections affect about 15% of the population and 20% of adults. Additionally, 70% of the population will experience athlete's foot at some point in life. Athlete's foot is common in individuals who wear unventilated (occlusive) footwear, such as rubber boots or vinyl shoes. Upon exposure to an athlete's foot-causing fungus, the moist conditions generated from poor foot ventilation promotes growth of the fungus on the foot or between the toes. Occupationally, studies have shown increased prevalence of athlete's foot among miners, soldiers, and athletes. Likewise, activities such as marathon running have seen increased prevalence of athlete's foot. Countries and regions where going barefoot is more common experience much lower rates of athlete's foot than do populations which habitually wear shoes; as a result, the disease has been called "a penalty of civilization". Studies have demonstrated that men are infected 2 to 4 times more often than women.Cases of athlete's foot were first documented around 1916 during World War I, where infection among soldiers was common. By 1928 it was estimated that nearly ten million Americans with cases of athlete's foot; the alarming prevalence of the disease caused for public health concern. In the following year, an epidemiologic study was conducted on incoming freshman to the University of California; it was found that 53% of incoming freshman men had athlete's foot and by year's end that number had risen to 78%. Prevalence of the disease increased in the 1930s, specifically among individuals of higher socioeconomic status; these individuals had more access to common shared spaced such as pools, colleges, and athletic clubs where transmission of athlete's foot-causing fungus was common. Prevalence in the United States was high enough to call for the use of sterilizing footbaths in the 1932 Olympics in Los Angeles. It was at this time public health officials adopted the idea that athletes foot was a product of modernity and that dealing with this disease was "a penalty of civilization" as many treatments proved ineffective. Antifungal properties of compounds such as undecylenic acid were studied in the 1940s; products containing zinc undecylenate were shown to be the most effective topical treatment for curing the condition. The use of orally ingested Griseofulvin was shown in the 1960s to be effective in acute cases of athlete's foot. Likewise, recorded incidence of athletes foot decreased among American soldiers in Vietnam who were given Griseofulvin as a preventative drug. In the 1990s, research supported the use of itraconazole and the Allylamine known as terbinafine as drugs effective at eliminating athlete's foot and also dermatophyte infections on other parts of the body. As of 2012, research has shown that terbinafine is 2.26 times as likely to cure athlete's foot than treatment with Griseofulvin; comparative studies between itraconazole and terbinafine have shown little difference in effectiveness.
Intractability: Tinea pedis, commonly known as athlete's foot, is generally not considered intractable. It is a manageable and treatable fungal infection with various over-the-counter and prescription antifungal medications. However, if left untreated, it can lead to more severe complications or become persistent. Effective hygiene practices and treatment adherence are key to resolving the infection.
Disease Severity: Disease severity for tinea pedis can vary depending on the extent and duration of the infection. It typically ranges from mild to severe. Mild cases may present with minor itching, scaling, and redness, while severe cases can involve extensive peeling, cracking, and even secondary bacterial infections.
Healthcare Professionals: Disease Ontology ID - DOID:12403
Pathophysiology: Tinea pedis, also known as athlete's foot, is a fungal infection primarily caused by dermatophytes, notably Trichophyton rubrum, Trichophyton interdigitale, and Epidermophyton floccosum. These fungi thrive in warm, moist environments such as between the toes, where they invade the keratinized tissues of the epidermis. The pathophysiology involves the fungus adhering to, colonizing, and proliferating on the stratum corneum of the skin. This leads to inflammation, scaling, and, in some cases, maceration and secondary bacterial infection.
Carrier Status: **Tinea pedis**, commonly known as athlete's foot, is a fungal infection affecting the skin of the feet. It is caused by dermatophytes, a group of fungi.

1. **Carrier Status**: Tinea pedis is not typically considered a condition with a "carrier status" in the same way as some bacterial or viral infections. However, individuals can harbor dermatophytes on their skin or in their shoes without showing symptoms, potentially spreading the infection to others.

2. **NaN**: "NaN" usually means "Not a Number" and is not applicable in the context of discussing the medical aspects of tinea pedis.

For general prevention:
- Keep feet clean and dry.
- Wear breathable footwear.
- Avoid walking barefoot in communal areas.
Mechanism: Tinea pedis, commonly known as athlete's foot, is a fungal infection of the skin on the feet, primarily caused by dermatophytes, including species like *Trichophyton rubrum* and *Trichophyton mentagrophytes*.

### Mechanism:
Tinea pedis occurs when dermatophytes invade the keratinized tissue of the stratum corneum, the outermost layer of the skin. The fungi thrive in warm, moist environments, making the feet an ideal location, especially in individuals who wear tight, non-breathable shoes or have sweaty feet. The infection typically starts in the web spaces between the toes and can spread to the soles of the feet.

### Molecular Mechanisms:
1. **Adhesion and Colonization**: Dermatophytes adhere to the keratinocytes using specific adhesion molecules. The fungi then colonize the superficial layer of the skin by secreting extracellular enzymes like keratinases, lipases, and proteases that degrade keratin and other structural proteins of the skin.

2. **Immune Evasion**: Dermatophytes can modulate the host immune response to facilitate infection. They produce molecules that can inhibit immune cell functions or avoid detection. For example, fungal metabolites may inhibit the activity of phagocytes and other immune cells.

3. **Invasion and Dissemination**: After adhering and beginning colonization, dermatophytes penetrate deeper layers of the stratum corneum. They use enzymes to break down host tissue, allowing them to spread further. The fungal cell wall components and secreted enzymes can also induce an inflammatory response, contributing to the clinical symptoms of redness, itching, and scaling.

4. **Keratin Degradation**: Dermatophytes produce keratinolytic enzymes such as keratinases, serine proteases, and cysteine proteases, which degrade keratin, the primary protein in the outer layer of the skin. This degradation provides nutrients for the fungi and helps them to survive and proliferate on the skin surface.

Understanding these mechanisms is crucial for developing effective treatments and preventive measures against tinea pedis.
Treatment: Athlete's foot resolves without medication in 30 to 40% of cases. Topical antifungal medication consistently produces much higher rates of cure.Conventional treatment typically involves thoroughly washing the feet daily or twice daily, followed by the application of a topical medication. Because the outer skin layers are damaged and susceptible to reinfection, topical treatment generally continues until all layers of the skin are replaced, about 2 to 6 weeks after symptoms disappear. Keeping feet dry and practicing good hygiene (as described in the above section on prevention) is crucial for killing the fungus and preventing reinfection.
Treating the feet is not always enough. Once socks or shoes are infested with funguses, wearing them again can reinfect (or further infect) the feet. Socks can be effectively cleaned in the wash by adding bleach or by washing in water 60 °C (140 °F).To be effective, treatment includes all infected areas (such as toenails, hands, torso, etc.). Otherwise, the infection may continue to spread, including back to treated areas. For example, leaving fungal infection of the nail untreated may allow it to spread back to the rest of the foot, to become athlete's foot once again.
Allylamines such as terbinafine are considered more efficacious than azoles for the treatment of athlete's foot.Severe or prolonged fungal skin infections may require treatment with oral antifungal medication.
Compassionate Use Treatment: Tinea pedis, commonly known as athlete's foot, typically responds well to standard antifungal treatments. In terms of compassionate use, off-label, or experimental treatments, there are a few considerations:

1. **Compassionate Use**: This is rarely applicable for tinea pedis given the effectiveness and availability of standard treatments. Compassionate use generally applies to more severe or life-threatening conditions lacking effective treatments.

2. **Off-label Treatments**: Some medications approved for other fungal infections can be used off-label for tinea pedis. For instance, oral antifungals like itraconazole or terbinafine, though typically used for more severe or extensive fungal infections, may be prescribed off-label for persistent or widespread tinea pedis when topical treatments fail.

3. **Experimental Treatments**: There have been some explorations into the use of new antifungal agents or alternative therapies, but these are generally within the realm of clinical trials. One emerging area of interest includes the use of nanoparticle-based antifungals which are still being researched.

For persistent or recurrent cases, it is important to consult a healthcare provider to determine the most appropriate course of action.
Lifestyle Recommendations: ### Lifestyle Recommendations for Tinea Pedis (Athlete's Foot)

1. **Keep Feet Dry**:
- Dry your feet thoroughly after washing, especially between the toes.
- Use a separate towel for your feet.

2. **Wear Breathable Footwear**:
- Choose shoes made of materials that allow air circulation, such as leather or mesh.
- Avoid wearing the same shoes two days in a row; let them air out.

3. **Use Antifungal Products**:
- Apply antifungal powder or spray daily to keep feet dry and prevent fungal growth.

4. **Practice Good Hygiene**:
- Wash your feet daily with soap and water.
- Change socks daily, and more frequently if they become damp.

5. **Avoid Walking Barefoot in Public Areas**:
- Wear flip-flops or shower shoes in communal showers, locker rooms, and around swimming pools.

6. **Keep Nails Trimmed and Clean**:
- Clean under your nails regularly to prevent fungal buildup.

7. **Avoid Sharing Personal Items**:
- Do not share shoes, socks, or towels with others.

8. **Opt for Moisture-Wicking Socks**:
- Use socks made of materials that wick moisture away from the skin, such as wool or synthetic blends.

9. **Manage Excessive Sweating**:
- Use antiperspirant on your feet if you experience excessive sweating.
- Consider using shoe inserts that absorb moisture.

Implementing these lifestyle changes can help prevent and manage tinea pedis effectively.
Medication: For tinea pedis (athlete's foot), over-the-counter antifungal medications are commonly used. These include topical treatments such as clotrimazole, miconazole, terbinafine, and tolnaftate. In more severe cases, prescription-strength medications or oral antifungals like itraconazole or fluconazole may be necessary. Always follow the specific directions for use and consult with a healthcare provider if symptoms persist.
Repurposable Drugs: Several drugs originally intended for other conditions have shown potential for repurposing in the treatment of tinea pedis (athlete's foot):

1. **Itraconazole**: Originally used for systemic fungal infections, it has shown efficacy in treating tinea pedis.
2. **Terbinafine**: Initially developed for other fungal infections, it is effective both topically and orally for tinea pedis.
3. **Griseofulvin**: Traditionally used for a variety of dermatophyte infections, it can be repurposed for persistent cases of tinea pedis.
4. **Ciclopirox**: Often used for nail fungus, it can also be applied topically for athlete's foot.
5. **Ketoconazole**: An antifungal that treats several fungal infections, including tinea pedis when used as a cream or shampoo.

These drugs can serve as alternatives especially in cases of resistant or recurrent tinea pedis.
Metabolites: Tinea pedis, also known as athlete's foot, is a fungal infection of the feet. It is primarily caused by dermatophytes, commonly Trichophyton rubrum. The specific metabolites produced by these fungi during infection are not commonly detailed in standard medical literature as they relate to the pathology of tinea pedis. However, common secondary metabolites found in dermatophytes may include various enzymes and toxins that facilitate the breakdown of keratin in the skin. Specific research into tinea pedis may identify more precise metabolites, but broadly, these are the chemical compounds associated with fungal activity in such infections.
Nutraceuticals: Nutraceuticals such as garlic extract (allicin), tea tree oil, and probiotics have been suggested to support treatment for tinea pedis (athlete’s foot). These may help due to their antimicrobial properties. However, it’s important to note that while they can complement traditional treatments, they should not replace antifungal medications unless advised by a healthcare professional.
Peptides: For tinea pedis, also known as athlete's foot, there is ongoing research into the use of peptides and nanotechnology for treatment.

Peptides: Antimicrobial peptides (AMPs) are being explored as potential treatments for fungal infections like tinea pedis due to their ability to target and destroy fungal cells.

Nanotechnology: Nanoparticles, such as silver or zinc oxide nanoparticles, are being investigated for their antifungal properties. They have shown promise in disrupting fungal cell membranes and enhancing the delivery of antifungal agents.

Both approaches aim to improve the efficacy of treatments and reduce the occurrence of fungal infections like tinea pedis.