Athlete’s Foot

Athlete's foot (also known as ringworm of the foot and tinea pedis) is a fungal infection of the skin that causes scaling, flaking, and itch of affected areas. It is typically transmitted in moist areas where people walk barefoot, such as showers or bathhouses. Although the condition typically affects the feet, it can spread to other areas of the body, including the groin. Athlete's foot can be prevented by good hygiene, and is treated by a number of pharmaceutical and other treatments.

Symptoms

Athlete's foot causes scaling, flaking, and itching of the affected skin. Blisters and cracked skin may also occur, leading to exposed raw tissue, pain, swelling, and inflammation. Secondary bacterial infection can accompany the fungal infection, sometimes requiring a course of oral antibiotics.

The infection can be spread to other areas of the body, such as the groin, and usually is called by a different name once it spreads, such as tinea corporis on the body or limbs and tinea cruris (jock itch or dhobi itch) for an infection of the groin. Tinea pedis most often manifests between the toes, with the space between the fourth and fifth digits most commonly afflicted.

Diagnosis

Diagnosis can be performed by a general practitioner, and by specialists such as a dermatologist or podiatrist.

Athlete's foot can usually be diagnosed by visual inspection of the skin, but where the diagnosis is in doubt direct microscopy of a potassium hydroxide preparation (known as a KOH test) may help rule out other possible causes, such as eczema or psoriasis. A KOH preparation is performed on skin scrapings from the affected area. The KOH preparation has an excellent positive predictive value, but occasionally false negative results may be obtained, especially if treatment with an anti-fungal medication has already begun.

If the above diagnoses are inconclusive or if a treatment regimen has already been started, a biopsy of the affected skin (i.e. a sample of the living skin tissue) can be taken for histological examination.

A Wood's lamp, although useful in diagnosing fungal infections of the hair (Tinea capitis), is not usually helpful in diagnosing tinea pedis since the common dermatophytes that cause this disease do not fluoresce under ultraviolet light. However, it can be useful for determining if the disease is due to a non-fungal afflictor.

Transmission

From person to person

Athlete's foot is caused by a parasitic fungus and is a communicable disease. It is typically transmitted in moist environments where people walk barefoot, such as showers, bath houses, and locker rooms. It can also be transmitted by sharing footwear with an infected person, or less commonly, by sharing towels with an infected person.

To other parts of the body

The various parasitic fungi that cause athlete's foot can also cause skin infections on other areas of the body, most often under toenails (Onychomycosis) or on the groin (tinea cruris).

Treatments

There are many conventional medications (over-the-counter and prescription) as well as alternative treatments for fungal skin infections, including athlete's foot. Important with any treatment plan is the practice of good hygiene. Several placebo controlled studies report that good foot hygiene alone can cure athlete's foot even without medication in 30-40% of the cases. However, placebo-controlled trials of allylamines and azoles for athlete’s foot consistently produce much higher percentages of cure than placebo.

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