Mycosis of the feet (dermatophytosis) is an infectious disease caused by pathogenic or opportunistic fungi. With mycosis, the skin of the feet peels and itches a lot, and in severe cases of the disease, it becomes red and swollen.
Definition of disease
Mycosis of the feet, or dermatophytosis, is an infectious disease caused by a dermatophyte fungus. In total, 43 types of dermatophytes are known, 30 of them lead to mycosis of the feet. Most often these are the fungi Trichophyton rubrum (90%), Trichophyton mentagrophytes and less often Epidermophyton. Mycosis of the feet is much less often caused by fungi of the genus Candida and the mold Scytalidium dimidiatum, Scytalidium hyalinum.
All dermatophytes have keratinolytic activity: they are able to dissolve keratin, the fibrous protein that forms 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 grow actively. However, fungi rarely penetrate deeper than the granular layer of the skin. Usually they are limited only to the upper, keratinized tissues.
Prevalence of athlete's foot
Mycoses of the skin, including those of the feet, are found in all countries of the world. The percentage of these diseases in the structure of all dermatological diseases reaches 37-40%.
At the same time, mycoses of the skin occur more often - in approximately 30% of cases.
According to dermatologists, up to 20% of the adult population suffers from mycosis of the feet. The pathology is found twice as often in men.
In people over 70, leg fungus is found in almost every second patient - this is explained by the fact that the elderly usually have chronic diseases associated with metabolic disorders, as well as vascular pathologies, such as varicose veins.
Infection with mycosis of the feet usually occurs in the family - through direct contact with the skin of an infected person. There are also known cases of infection when you share 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-leg-one-hand syndrome.
Causes of mycosis of the feet
Most often, foot mycosis is caused by dermatophyte fungi - Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum. Much less often, the disease is provoked by fungi of the genus Candida (Candida) and mold (Scytalidium dimidiatum, Scytalidium hyalinum).
According to some studies, the percentage of dermatophytes in the structure of the causative agents of foot mycosis is gradually decreasing. Candida fungi come to the fore.
Risk factors for the development of mycosis of the feet:
- violation of personal hygiene;
- shoe sharing (for example, at bowling alleys, skate and ski rental shops);
- visits to public baths, swimming pools, beaches;
- climatic features: the risk of getting sick is higher in countries with a subtropical and tropical climate - this is due to increased humidity and ambient temperature;
- constantly wearing closed, narrow shoes (this happens among military personnel, miners, workers in the textile and metallurgical industry);
- 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 dermatosis;
- obesity;
- diabetes;
- chronic venous insufficiency;
- taking certain medications (systemic glucocorticosteroids).
Symptoms of mycosis of the feet
The symptoms of mycosis of the feet, as well as the features of the treatment of the disease, depend on its clinical form.
The 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 is disturbed by moderate peeling of the skin between the fingers - the scales on the skin are abundant, thin and silvery in color. Then, as the disease spreads to the lateral and dorsal surfaces of the legs, 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 mycosis
This form often develops against the background of heavy sweating of the feet. The disease affects the spaces between the toes and is accompanied by redness, swelling and maceration (softening and loosening of the skin). Erosion and cracks are often formed. Many patients report itching, burning and pain.
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 (flaky epidermophyton).
The dyshidrotic form of mycosis of the feet, as a rule, is more severe and is accompanied by itching and painful pain. Blisters with a thick covering form on the skin. Merging, they form large multi-chambered blisters, which after opening turn into pink-red wet 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, the interdigital folds and the skin of the fingers. The process can then spread to the heels, the lateral surfaces of the lower legs 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 leg appears and the skin is 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 touched. The process then spreads to the sole, the dorsal and lateral surfaces of the foot and the nail plates. Blisters and erosions appear on the skin, which are then covered with crusts. The skin becomes wet and may be irritated.
The obliterated form of mycosis of the feet
The deleted form has been identified by several researchers. It is believed to occur a few days after infection with the fungus.
The skin in the interdigital folds begins to peel. There may also be light skin on the soles and sides of the feet. Patients may ignore unpleasant symptoms, but they still infect others.
Acute form of foot mycosis
The acute form of mycosis of the feet is the result of an aggravation 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 on the feet. The skin swells. Joints then form in the hands and lower third of the forearms.
After the blisters open, erosions appear, surrounded by pieces of loose skin. They melt, turning into wide weeping surfaces, often with purulent discharge.
The disease is often accompanied by fever, worsening of the patient's general condition and sharp pains in the affected hands and feet. The inguinal and femoral lymph nodes become enlarged and 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: strong itching, reddening of the skin, localized mainly on the soles, at the base and sides of the toes, on the back of the foot. Swollen areas with blisters may appear on the surface. Bubbles can merge or remain unchanged for a long time - if the tire (upper part) is thick enough.
Often the nail plates are also 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 mycosis of the feet, caused by the addition of a bacterial infection.
Wide deep purulent ulcers form on the soles. The patient experiences severe pain and, as a result, difficulty in walking.
Complications of foot mycosis
Cracks and ulcers in the skin that appear at the site of mycosis are the gateways 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 mycosis of the feet:
- allergic dermatitis of infectious and medicinal origin;
- pyoderma - pustular skin diseases (cellulitis, lymphangitis, phlegm, osteomyelitis of the leg bones), which can lead to deep and long-term skin wounds;
- plantar warts;
- microbial eczema is a chronic inflammatory disease in which the skin itches and reddens, and fluid-shaped blisters on it;
- 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 on the skin of the hands and nail plates;
- 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.
At 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. In parallel with the examination, the specialist will collect the anamnesis and ask the patient about his lifestyle, quality of nutrition, household habits and care procedures.
If you suspect athlete's foot, your doctor will order lab tests.
Examination of skin scrapings will rule out or confirm a fungal infection.
The doctor may also refer the patient for microscopic examination and culture.
Sowing, or the cultural 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 mycosis of the feet and lead to serious complications. Complex studies can exclude or confirm this diagnosis.
A complete blood count helps to assess the general condition of the patient.
The clinical blood test is a blood test that allows you to assess your general health, identify inflammation, bacterial, viral and fungal infections and can also help diagnose anemia, diseases of hematopoietic organs, allergic reactions and autoimmune diseases.
Also, before recommending antifungal therapy, the doctor can prescribe the patient a biochemical blood test - 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 mycosis of the feet
Treatment of mycosis of the feet is carried out in two stages.
In the first stageIf there is acute inflammation, creams are used: aqueous solutions of ammonium bituminous sulfonate, agents with antiseptic properties (Castellani liquid, 1% aqueous solution of brilliant green). Then pastes and ointments containing antifungal drugs and glucocorticosteroids are prescribed.
In case of severe weeping (in the acute phase) and the addition of a secondary infection, anti-inflammatory solutions are used as creams, as well as combined antibacterial drugs in the form of creams and solutions.
The basis of therapy is the use of antimycotic - antifungal agents.
In the main stagetreatment uses antifungal drugs designed to destroy pathogenic fungi. Most often, such medications are produced in the form of ointments, creams or solutions.
If the patient is bothered by 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 medications do not work, systemic antimycotic agents are prescribed.
The treatment regimen and the dosage of drugs are determined by the doctor. During treatment, it is necessary to visit a pediatrician at least once a month.
Prognosis and prevention
If you consult a doctor at the right time, the prognosis for mycosis of the feet 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 socks daily or more often if your feet are sweaty or wet;
- air or dry shoes after wearing;
- use a UV antifungal shoe dryer;
- do not wear shared slippers when visiting;
- don't try on shoes in a store with bare feet;
- use a personal towel for your feet;
- 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?
For the treatment of foot fungus, antifungal drugs are usually used, 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.