Mycosis of the feet (dermatophytosis) is an infectious disease caused by pathogenic or opportunistic fungi. In case of mycosis, the skin on the legs peels and itches very much, and in more severe cases of the disease, it becomes red and swollen.
Definition of disease
Foot mycosis or dermatophytosis is an infectious disease caused by a dermatophyte mold. A total of 43 types of dermatophytes are known, of which 30 lead to foot mycosis. The most common fungi are Trichophyton rubrum (90%), Trichophyton mentagrophytes, and less commonly Epidermophyton. Mycosis of the feet is much less often caused by fungi of the genus Candida and the molds Scytalidium dimidiatum, Scytalidium hyalinum.
All dermatophytes have keratinolytic activity: they are able to dissolve 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 to the most vulnerable places - the junctions between the cells of the epidermis. There they penetrate inside and begin to actively grow. However, fungi rarely penetrate deeper than the granular layer of the skin. They are usually limited to only the upper, keratinized tissues.
Prevalence of athlete's foot
Mycoses of the skin, including foot mycoses, are found 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, mycoses of the skin occur most often - in approximately 30% of cases.
According to dermatologists, up to 20% of the adult population suffers from mycosis of the feet. Pathology is found twice as often in men.
Among people older than 70, foot fungus is found in almost every second patient - this is explained by the fact that older people usually have chronic diseases associated with metabolic disorders, as well as vascular pathologies, such as varicose veins.
Infection with foot mycosis most often occurs 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 on the working hand. This condition is called two feet and one hand syndrome.
Causes of athlete's foot
The most common foot mycosis 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 share of dermatophytes in the causative structure of foot mycosis is gradually decreasing. Candida mushrooms come to the fore.
Risk factors for foot mycosis:
- violation of personal hygiene;
- sharing shoes (for example, at bowling alleys, skate and ski rental shops);
- visiting public baths, swimming pools, beaches;
- climatic characteristics: the risk of disease is higher in countries with a subtropical and tropical climate - this is due to increased humidity and temperature of the environment;
- constant wearing of closed, narrow shoes (this happens among military personnel, miners, workers in the textile and metallurgical industries);
- frequent toe injuries due to flat feet, calluses, corns;
- non-observance of sanitary rules during pedicure;
- disturbed blood flow to the legs;
- immunodeficiency conditions, including HIV;
- chronic dermatoses;
- obesity;
- diabetes;
- chronic venous insufficiency;
- taking certain medications (systemic glucocorticosteroids).
Symptoms of foot mycosis
The symptoms of mycosis of the feet, as well as the characteristics of the treatment of the disease, depend on its clinical form.
Squamous (squamous-hyperkeratotic) form of foot mycosis
In most cases, the causative agent of the squamous form of foot mycosis is the dermatophyte Trichophyton rubrum.
In the initial stage of the disease, the patient suffers from moderate peeling of the skin between the fingers - the scales on the skin are abundant, thin, silvery in color. Then, as the disease spreads to the lateral and dorsal surfaces of the feet, a characteristic inflammatory ridge appears, and the skin on the affected areas thickens. Over time, the patient develops onychomycosis - nail fungus.
Intertriginous (interdigital) form of foot mycosis
This form often develops against the background of heavy sweating of the feet. The disease affects the spaces between the fingers and is accompanied by redness, swelling and maceration (softening and loosening of the skin). Erosions and cracks are often formed. Many patients report itching, burning and pain.
A simultaneous infection of the skin of the feet with dermatophyte fungi (usually Trichophyton mentagrophytes var. interdigitale) and Staphylococcus aureus bacteria often occurs.
Dyshidrotic form of foot mycosis
As a rule, the causative agent of this form of foot mycosis is Epidermophyton floccosum (scaly epidermophyton).
As a rule, the dyshidrotic form of foot mycosis is more severe and is accompanied by painful itching and pain. Blisters with a thick covering form on the skin. Merging, they form large multichamber blisters, which after opening turn into moist 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 the skin of the fingers. The process can then spread to the heels, lower sides of the feet, and even the skin below the ankles.
If a bacterial infection occurs, the patient may develop a fever and regional lymph nodes will become enlarged. Swelling of the foot appears, and the skin on it becomes wet. Severe pain makes it difficult for the patient to walk.
Exudative-dyshidrotic form of foot mycosis
Most often, the exudative-dyshidrotic form of foot mycosis is caused by the fungus Trichophyton rubrum (red trichophyton).
First, the skin between the fingers is affected. Then the process spreads to the soles, dorsal and lateral surfaces of the feet, and nail plates. Blisters and erosions appear on the skin, which are then covered with crusts. The skin becomes moist and may fester.
Eradicated form of foot mycosis
Some researchers identify a deleted form. It is believed to occur several days after infection with the fungus.
The skin in the interdigital folds begins to peel. Mild peeling may also occur on the soles and sides of the feet. Patients may ignore unpleasant symptoms, but still infect others.
Acute form of foot mycosis
The acute form of foot mycosis is the result of worsening dyshidrotic or intertriginous (interdigital) form.
The disease begins acutely: a large number of blisters appear on the skin of the feet and then on the legs. The skin swells. Then knots form on the hands and the lower third of the forearms.
After the blisters open, erosions appear, surrounded by pieces of loose skin. They merge, turning into large weeping areas, often with purulent discharge.
The disease is often accompanied by an elevated temperature, worsening of the patient's general condition, and sharp pain in the affected hands and feet. Inguinal and femoral lymph nodes enlarge and become painful.
Vesiculobullous (inflammatory) form of foot mycosis
The inflammatory form of foot mycosis is usually 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 on the skin, localized mainly on the soles, at the base and on the sides of the toes, on the back of the feet. Swelling with blisters on the surface may occur. Bubbles can coalesce or remain unchanged for a long time - if the tire (top) is thick enough.
Often the nail plates are involved in the process - onychomycosis develops.
Ulcerative form of foot mycosis
The ulcerative form (called deep in foreign literature) is one of the complications of foot mycosis, caused by the addition of bacterial infection.
Extensive, deep, purulent ulcers form on the soles of the feet. The patient feels severe pain and, as a result, difficulty walking.
Complications of foot mycosis
Cracks and ulcers on the skin that appear at the site of mycosis are the entrance door for bacterial infections. However, it is more difficult to treat such infections - this is explained by the fact that fungi produce special substances that increase the resistance of bacteria to drugs.
The most common complications of foot mycosis:
- allergic dermatitis of infectious and medicinal origin;
- pyoderma - pustular skin diseases (cellulitis, lymphangitis, phlegmon, osteomyelitis of the bones of the foot), which can lead to deep, long-lasting wounds on the skin;
- plantar warts;
- microbial eczema is a chronic inflammatory disease in which the skin itches and becomes red, and blisters appear on it in the form of liquid;
- a general decrease in immunity and impaired microcirculation in the lower extremities (usually develops in patients with diabetes mellitus and varicose veins);
- the spread of the disease to the skin of the hands and the nail plate;
- deterioration of the 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 mycosis
A dermatologist-mycologist deals with the diagnosis and treatment of mycosis of the feet.
During the examination, the doctor will assess the condition of the patient's nails, skin, mucous membrane and hair. He will conduct a dermatoscopy - examine the skin under magnification. In parallel with the examination, the specialist will collect the medical history and ask the patient about his lifestyle, quality of diet, household habits and care procedures.
If you suspect athlete's foot, your doctor will prescribe laboratory tests.
Examination of skin scrapings will rule out or confirm a fungal infection.
The doctor may also refer the patient for a microscopic examination and culture.
Sowing, or the culture method, allows you to get more accurate information about the causative agent of the disease, although it takes longer - usually a month.
Diabetes mellitus can significantly worsen the course of foot mycosis and lead to serious complications. Complex studies can exclude or confirm this diagnosis.
A complete blood count helps to assess the patient's general condition.
A clinical blood test is a blood test that allows you to assess your general state of health, identify inflammation, bacterial, viral and fungal infections, and can also help diagnose anemia, diseases of the blood-forming organs, allergic reactions and autoimmune diseases.
Also, before recommending antifungal therapy, the doctor may prescribe a biochemical blood test for the patient - this study will determine the level of bilirubin and liver enzymes ALT and AST. Such information will help the doctor to choose the dose of the drug and minimize the risk of side effects.
Treatment of foot mycosis
Treatment of mycosis of the foot is carried out in two stages.
In the first phaseIf there is acute inflammation, lotions are used: aqueous solutions of ammonium bitumen sulfonate, agents with antiseptic properties (Castellani liquid, 1% aqueous solution of brilliant green). Pastes and ointments containing antifungal and glucocorticosteroid drugs are then prescribed.
In the case of strong crying (in the acute phase) and the addition of secondary infection, anti-inflammatory solutions are used as lotions, as well as combined antibacterial drugs in the form of creams and solutions.
The basis of therapy is the use of antifungal agents.
On the main stagetreatment uses antifungal drugs designed to destroy pathogenic fungi. Most often, such drugs are produced in the form of ointments, creams or solutions.
If the patient is suffering from severe itching, the dermatologist can prescribe antihistamines. They are usually taken for 10-15 days, until the unpleasant symptom disappears completely.
When the 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 surface of the nail and does not penetrate into the bloodstream, eliminating the risk of side effects.
If external drugs do not work, systemic antimycotics are prescribed.
The treatment regimen and medication dosage is determined by the doctor. During the treatment, it is necessary to visit the pediatrician at least once a month.
Prognosis and prevention
If you consult a doctor in a timely manner, the prognosis for foot mycosis is favorable: most patients treated with antifungal drugs get rid of the disease forever.
To prevent mycosis, you need to 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;
- breathable or dry shoes after wearing;
- use an antifungal UV shoe dryer;
- do not wear shared slippers when visiting;
- don't try on shoes in a store with bare feet;
- use a personal foot towel;
- use individual nail care tools (tweezers, files);
- wear shoes in the pool or sauna;
- monitor the variety of your diet;
- avoid stressful situations.
FAQ
How to cure foot fungus?
Antimycotic drugs are commonly used to treat toenail fungus, which are available in the form of creams, ointments, and solutions. A dermatologist should choose the most effective drug and determine its dosage.
Why do my feet itch?
One of the causes of itchy feet is athlete's foot, an infectious disease caused by a dermatophyte fungus.