Foot fungus (dermatophytosis) is an infectious disease caused by pathogenic or opportunistic fungi. With mycosis, the skin on the legs peels off and causes severe itching. In severe cases of the disease, it turns red and swells.
Definition of disease
Foot fungus, or dermatophytosis, is an infectious disease caused by dermatophyte molds. In total, 43 species of dermatophytes are known, 30 of which cause foot fungus. These are most often the mushrooms Trichophyton rubrum (90%), Trichophyton mentagrophytes and, more rarely, Epidermophyton. Foot fungus is caused much less frequently by fungi of the genus Candida and molds Scytalidium dimidiatum, Scytalidium hyalinum.
All dermatophytes have keratinolytic activity: they are capable of dissolving keratin, the fibrous protein that makes up the upper part of the skin of humans and animals. The skin is damaged.
Once on the skin, the fungi are directed towards the most vulnerable places: the junctions between the cells of the epidermis. There they get inside and begin to actively grow. However, fungi rarely penetrate deeper than the granular layer of the skin. They are generally limited to the upper keratinized tissues.
Prevalence of foot fungus
Skin fungus, particularly foot fungus, is present in all countries of the world. The share of these diseases in the structure of all dermatological diseases reaches 37-40%.
At the same time, skin mycoses occur most often - in about 30% of cases.
According to dermatologists, up to 20% of the adult population suffers from foot fungus. The pathology is found twice as often in men.
In people over 70 years old, foot fungus is present in almost every second patient - this is explained by the fact that older people usually suffer from chronic diseases associated with metabolic disorders, as well as pathologiesvascular diseases, such as varicose veins.
Foot fungus infection usually runs in the family - through direct contact with the skin of an infected person. There are also known cases of infection when sharing clothes, shoes and household items.
The infection usually affects both feet at once and partially spreads to the nail plates. Without treatment, the disease can also affect the skin of the palm, usually that of the working hand. This condition is called two feet and one hand syndrome.
Causes of foot fungus
Most often, foot fungus is caused by dermatophyte fungi - Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum. Much less often, the disease is caused by fungi of the genus Candida (Candida) and mold (Scytalidium dimidiatum, Scytalidium hyalinum).
According to some studies, the proportion of dermatophytes in the structure of the causative agents of foot fungus gradually decreases. Candida mushrooms are highlighted.
Risk factors for developing foot fungus:
- violation of personal hygiene;
- share shoes (for example, at bowling alleys, skate and ski rental stores);
- visiting public baths, swimming pools, beaches;
- climatic features: the risk of getting sick is higher in countries with subtropical and tropical climates - this is due to increased humidity and ambient temperature;
- constantly wear closed, tight shoes (this happens among military personnel, miners, workers in the textile and metallurgical industries);
- frequent toe injuries due to flat feet, calluses, corns;
- non-compliance with sanitary rules during pedicure;
- impaired blood supply to the legs;
- immunodeficiency conditions, including HIV;
- chronic dermatoses;
- obesity;
- diabetes;
- chronic venous insufficiency;
- take certain medications (systemic glucocorticosteroids).
Symptoms of foot fungus
Symptoms of foot fungus, as well as features of treatment of the disease depend on its clinical form.
Scaly (squamous-hyperkeratotic) form of foot fungus
In most cases, the causative agent of the scaly form of foot fungus is the dermatophyte Trichophyton rubrum.
At the initial stage of the disease, the patient is bothered by moderate peeling of the skin between the fingers - the scales on the skin are abundant, thin and silver in color. Then, as the disease spreads to the lateral and dorsal surfaces of the feet, a characteristic inflammatory ridge appears and the skin in the affected areas thickens. Over time, the patient develops onychomycosis - nail fungus.
Intertriginous (interdigital) form of foot fungus
This form often develops against the background of profuse sweating of the feet. The disease affects the spaces between the fingers and is accompanied by redness, swelling and macerations (softening and loosening of the skin). Erosion and cracks often form. Many patients report itching, burning and pain.
Often, a simultaneous infection of the skin of the feet with dermatophyte fungi (usually Trichophyton mentagrophytes var. interdigitale) and the bacteria Staphylococcus aureus occurs.
Dyshidrotic form of foot fungus
As a rule, the causative agent of this form of foot mycosis is Epidermophyton floccosum (epidermophyton laminated).
The dyshidrotic form of foot fungus is usually more serious and is accompanied by painful itching and pain. Thickly covered blisters form on the skin. When merging, they form large multi-chamber blisters, which, after opening, turn into wet pink-red erosions and then into brown crusts.
The disease is difficult to treat and often recurs.
A characteristic feature of the dyshidrotic form is damage to the arch of the foot, interdigital folds and skin of the fingers. The process can then spread to the heels, lower lateral surfaces of the feet, and even the skin below the ankles.
If a bacterial infection occurs, the patient may develop a fever and the regional lymph nodes will enlarge. Swelling of the foot appears and the skin becomes moist. Severe pain makes it difficult for the patient to walk.
Exudative-dyshidrotic form of foot fungus
Most often, the exudative-dyshidrotic form of foot mycosis is caused by the fungus Trichophyton rubrum (red trichophyton).
The skin between the fingers is the first affected. Then the process extends to the sole of the foot, the dorsal and lateral surfaces of the foot and the nail plates. Blisters and erosions appear on the skin, which then becomes covered with scabs. The skin becomes moist and can become infected.
Clear form of foot fungus
The erased form is identified by some researchers. This is thought to happen a few days after infection with the fungus.
The skin in the interdigital folds begins to peel off. There may also be slight peeling on the soles and sides of the feet. Patients may ignore unpleasant symptoms, but they still infect others.
Acute form of foot fungus
The acute form of foot mycosis is the result of an exacerbation of the dyshidrotic or intertriginous (interdigital) form.
The disease begins acutely: a large number of blisters appear on the skin of the feet and then the legs. The skin swells. Then nodules form on the hands and lower third of the forearms.
Once the blisters open, erosions appear, surrounded by flaps of loose skin. They merge and turn into large oozing surfaces, often accompanied by purulent discharge.
The disease is often accompanied by fever, deterioration in the general condition of the patient and sharp pain in the affected hands and feet. The inguinal and femoral lymph nodes enlarge and become painful.
Vesiculobullous (inflammatory) form of foot fungus
The inflammatory form of foot mycosis is generally identified by foreign authors, often defining it as acute. It can develop from a chronic interdigital form of dermatophytosis.
As a rule, the causative agent of the vesiculobullous form is the dermatophyte Trichophyton rubrum.
Main symptoms: severe itching, rash, located mainly on the soles of the feet, at the base and sides of the fingers, on the back of the foot. Areas of swelling with surface blisters may appear. The bubbles can merge or remain unchanged for a long time - if the tire (upper part) is thick enough.
Often, nail plates are also involved in the process - onychomycosis develops.
Ulcerative form of foot fungus
The ulcerative form (in foreign literature it is called deep) is one of the complications of foot mycosis, caused by the addition of a bacterial infection.
Deep and extensive purulent ulcers form on the soles of the feet. The patient experiences severe pain and, as a result, difficulty walking.
Complications of foot fungus
Cracks and ulcers on the skin that appear at the site of the fungus are the entry points for bacterial infections. However, it is more difficult to treat such infections. This is because fungi produce special substances that increase the resistance of bacteria to drugs.
The most common complications of foot fungus:
- allergic dermatitis of infectious and drug origin;
- pyoderma - pustular skin diseases (cellulitis, lymphangitis, phlegmon, osteomyelitis of the bones of the foot), which can lead to deep and lasting skin wounds;
- plantar warts;
- microbial eczema is a chronic inflammatory condition in which the skin becomes itchy and red, and blisters containing fluid form on it;
- a general decrease in immunity and impaired microcirculation in the lower extremities (usually develops in patients with diabetes mellitus and varicose veins);
- spread of the disease to the skin of the hands and nails;
- deterioration in quality of life: in acute forms of mycosis, it is difficult to wear shoes, and lymphadenitis leads to fever and poor health.
Diagnosis of foot fungus
A dermatologist-mycologist deals with the diagnosis and treatment of foot fungus.
During the appointment, the doctor will assess the condition of the patient's nails, skin, mucous membranes and hair. He will perform a dermatoscopy - examine the skin under magnification. Along with the examination, the specialist will collect the history and ask the patient about his lifestyle, the quality of his diet, his household habits and his care procedures.
If you suspect athlete's foot, your doctor will order laboratory tests.
Examination of skin scrapings will exclude or confirm fungal infection.
The doctor may also refer the patient for microscopic examination and culture.
Sowing, or cultural method, allows you to obtain more accurate information about the causative agent of the disease, although it takes more time - usually a month.
Diabetes mellitus can significantly worsen the course of foot fungus and lead to serious complications. Complex studies can exclude or confirm this diagnosis.
A complete blood count makes it possible to assess the patient's general condition.
A clinical blood test is a blood test that helps assess your general health, identify inflammation, bacterial, viral and fungal infections, and can also help in the diagnosis of anemia, organ diseaseshematopoietic disorders, allergic reactions and autoimmune diseases.
Additionally, before recommending antifungal treatment, the doctor may prescribe the patient a biochemical blood test - this study will determine the level of bilirubin and liver enzymes ALT and AST. This information will help the doctor choose the dosage of the drug and minimize the risk of side effects.
Treatment of foot fungus
Treatment of foot fungus is carried out in two stages.
At the first stageIn case of acute inflammation, lotions are used: aqueous solutions of ammonium bituminous sulfonate, agents with antiseptic properties (Castellani liquid, 1% aqueous solution of brilliant green). Then pastes and ointments are prescribed containing antifungal and glucocorticosteroid drugs.
In case of severe oozing (in the acute phase) and the addition of a secondary infection, anti-inflammatory solutions are used in the form of lotions, as well as combined antibacterial drugs in the form of creams and solutions.
The basis of therapy is the use of antimycotic - antifungal agents.
On the main stageTreatment uses antifungal medications designed to destroy pathogenic fungi. Most often, these drugs are produced in the form of ointments, creams or solutions.
If the patient is bothered by severe itching, the dermatologist may prescribe antihistamines. They are usually taken for 10-15 days, until the unpleasant symptom disappears completely.
When nails are damaged, antifungal agents are used - they are applied directly to the nail plate and nail folds. In this case, the drug is concentrated on the nail surface and does not enter the bloodstream, eliminating the risk of side effects.
If external medications do not produce any effect, systemic antimycotic agents are prescribed.
The treatment regimen and dosage of drugs are determined by the doctor. During treatment, it is necessary to consult a podiatrist at least once a month.
Prognosis and prevention
If you consult a doctor in time, the prognosis for foot fungus is favorable: most patients treated with antifungal drugs permanently get rid of the disease.
To prevent fungal infections, you must protect your feet and hands from irritating and traumatic factors and strengthen your immune system.
Measures to prevent onychomycosis:
- change your socks every day or more often if your feet are sweaty or wet;
- air or dry shoes after wearing them;
- use an antifungal UV shoe dryer;
- do not wear shared slippers during your visit;
- do not try on shoes in a store barefoot;
- use a personal towel for your feet;
- use individual tools for nail care (nippers, files);
- wear shoes in the pool or sauna;
- monitor the diversity of your diet;
- avoid stressful situations.
FAQs
How to treat foot fungus?
To treat fungus on the legs, antimycotic drugs are usually used, available in the form of creams, ointments and solutions. A dermatologist must choose the most effective drug and determine its dosage.
Why do my feet itch?
One of the causes of itchy feet is foot fungus, an infectious disease caused by dermatophyte molds.