Mycosis of the feet (dermatophytosis) is an infectious disease caused by pathogenic or opportunistic fungi. With mycosis, the skin on the legs peels off and itches severely; in severe cases, it becomes red and swollen.
Definition of illness
Mycosis of the feet or dermatophytosis is an infectious disease caused by dermatophyte fungi. A total of 43 species of dermatophytes are known, 30 of which lead to mycosis of the feet. The most common are the fungi Trichophyton rubrum (90%), Trichophyton mentagrophytes and, less commonly, Epidermophyton. Mycoses of the feet are much less commonly caused by fungi of the genus Candida and the molds Scytalidium dimidiatum and 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 areas - the connections between the cells of the epidermis. There they penetrate inside and begin to actively grow. However, fungi rarely penetrate deeper than the granular skin layer. Usually they are limited only to the upper, keratinized tissue.
Prevalence of mycoses of the feet
Mycoses of the skin, including mycoses of the feet, occur in all countries of the world. The share of these diseases in the structure of all dermatological diseases is 37-40%.
At the same time, mycoses of the skin occur most frequently - in around 30% of cases.
According to dermatologists, up to 20% of the adult population suffers from foot mycoses. Pathologies occur twice as often in men.
In people over 70 years old, athlete's foot occurs in almost every second patient - this is explained by the fact that older people usually suffer from chronic diseases that are accompanied by metabolic disorders, as well as vascular diseases such as varicose veins.
Infection with mycoses of the feet usually runs in families - through direct contact with the skin of an infected person. Cases of infection are also known when sharing clothing, shoes and household items.
The infection usually affects both feet at the same time and sometimes 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-foot-one-hand syndrome.
Causes of mycosis of the feet
Most often, mycosis of the feet 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 molds (Scytalidium dimidiatum, Scytalidium hyalinum).
According to some studies, the proportion of dermatophytes in the structure of pathogens of foot mycosis is gradually decreasing. Candida fungi come to the fore.
Risk factors for developing foot mycosis:
- violation of personal hygiene;
- Sharing shoes (e. g. in bowling alleys, skate and ski rentals);
- Visiting public baths, swimming pools, beaches;
- Climatic features: In countries with subtropical and tropical climates, the risk of disease is higher - this is due to increased humidity and ambient temperature;
- constantly wear closed, tight shoes (this happens with military personnel, miners, workers in the textile and metal industries);
- frequent injuries to the toes due to flat feet, calluses, corns;
- Failure to comply with hygiene rules during pedicure;
- impaired blood supply to the legs;
- immunodeficiency conditions, including HIV;
- chronic dermatoses;
- Obesity;
- diabetes mellitus;
- chronic venous insufficiency;
- Taking certain medications (systemic glucocorticosteroids).
Symptoms of mycosis of the feet
The symptoms of foot mycosis, as well as the features of the treatment of the disease, depend on its clinical form.
Squamous cell carcinoma (squamous cell hyperkeratotic) form of mycosis of the feet
In most cases, the causative agent of squamous mycosis of the feet is the dermatophyte Trichophyton rubrum.
In the initial stages 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 silvery in color. As the disease then spreads to the side and back 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 mycosis of the feet
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 often form. Many patients report itching, burning and pain.
There is often a simultaneous infection of the foot skin with dermatophyte fungi (usually Trichophyton mentagrophytes var. interdigitale) and the bacterium Staphylococcus aureus.
Dyshidrotic form of mycosis of the feet
The causative agent of this form of mycosis of the feet is usually Epidermophyton floccosum (scaly epidermophyton).
The dyshidrotic form of foot mycosis is usually more severe and is accompanied by painful itching and pain. Blisters form on the skin with a thick layer. By merging, they form large multi-chambered bubbles, which, when opened, 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, the lower sides 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 enlarge. The foot swells and the skin on it becomes wet. Severe pain makes it difficult for the patient to walk.
Exudative-dyshidrotic form of mycosis of the feet
Most often, the exudative-dyshidrotic form of foot mycosis is caused by the fungus Trichophyton rubrum (red Trichophyton).
The skin between the fingers is initially affected. The process then spreads to the sole of the foot, the back and sides of the foot and the nail plates. Blisters and erosions appear on the skin, which then become covered with crusts. The skin becomes wet and can fester.
Erased form of mycosis of the feet
The deleted form is identified by some researchers. It is believed to occur 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 still infect others.
Acute form of mycosis of the feet
The acute form of mycosis of the feet is the result of an exacerbation of the dyshidrotic or intertriginous (interdigital) form.
The disease begins acutely: numerous blisters form on the skin of the feet and then the legs. The skin swells. Then nodules form on the hands and in the lower third of the forearms.
After the blisters open, erosions appear surrounded by loose pieces of skin. They merge to form extensive weeping areas, often with purulent discharge.
The disease is often accompanied by fever, a deterioration in the patient's general condition and severe pain in the affected hands and feet. The inguinal and femoral lymph nodes enlarge and become painful.
Vesiculobullous (inflammatory) form of mycosis of the feet
The inflammatory form of mycosis of the feet is usually identified by foreign authors and is often defined as acute. It can develop from a chronic interdigital form of dermatophytosis.
The causative agent of the vesiculobullous form is usually the dermatophyte Trichophyton rubrum.
Main symptoms: severe itching, rashes, mainly localized on the soles of the feet, at the base and sides of the fingers, on the back of the feet. Swelling areas with bubbles on the surface may occur. The bubbles can merge or remain unchanged for a long time - if the tire (upper part) is thick enough.
The nail plates are often also involved in the process - onychomycosis develops.
Ulcerative form of mycosis of the feet
The ulcerative form (in foreign literature it is called deep) is one of the complications of mycosis of the feet, caused by the addition of a bacterial infection.
Extensive, deep purulent ulcers form on the soles of the feet. The patient feels severe pain and therefore difficulty walking.
Complications of mycosis of the feet
Cracks and ulcers on the skin that arise at the site of mycosis are the entry point for bacterial infections. However, treating such infections is more difficult - this is because 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 drug origin;
- Pyoderma – pustular skin diseases (cellulitis, lymphangitis, cellulitis, osteomyelitis of the bones of the foot), which can lead to deep, long-lasting skin wounds;
- plantar warts;
- Microbial eczema is a chronic inflammatory disease in which the skin itches, becomes red and blisters with fluid form on it.
- a general decrease in immunity and impaired microcirculation in the lower extremities (usually arises in patients with diabetes mellitus and varicose veins);
- Spread of the disease to the skin of the hands and nail plates;
- Deterioration in quality of life: In acute forms of mycosis, wearing shoes is difficult, lymphadenitis leads to fever and poor health.
Diagnosis of mycosis of the feet
A dermatologist-mycologist deals with the diagnosis and treatment of mycoses of the feet.
At the appointment, the doctor assesses the condition of the patient's nails, skin, mucous membranes and hair. He will perform a dermoscopy – examining the skin under magnification. At the same time as the examination, the specialist takes an anamnesis and asks the patient about his lifestyle, the quality of his diet, his household habits and care measures.
If you suspect athlete's foot, your doctor will order laboratory tests.
By examining skin abrasions, a fungal infection can be ruled out or confirmed.
The doctor may also refer the patient for microscopic examination and culture.
The sowing or culture method allows you to get more accurate information about the causative agent of the disease, although this takes longer - usually a month.
Diabetes mellitus can significantly worsen the course of mycosis of the feet and lead to serious complications. Extensive studies can rule out 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 health, detect inflammation, bacterial, viral and fungal infections, and can also help diagnose anemia, diseases of the hematopoietic organs, allergic reactions and autoimmune diseases.
In addition, before recommending antifungal therapy, the doctor may prescribe the patient a biochemical blood test. In this study, bilirubin levels and the liver enzymes ALT and AST are determined. Such information will help the doctor select the dosage of the drug and minimize the risk of side effects.
Treatment of mycoses of the feet
Treatment of mycosis of the feet occurs in two steps.
In the first phaseFor acute inflammation, lotions are used: aqueous solutions of ammonium bitumen sulfonate, agents with antiseptic properties (Castellani liquid, 1% aqueous solution of brilliant green). Then pastes and ointments containing antifungal and glucocorticosteroids are prescribed.
In case of severe weeping (in the acute phase) and additional 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 antifungal – antifungal – active ingredients.
On the main stageTreatment uses antifungal drugs that are designed to destroy pathogenic fungi. Most often, such drugs are produced in the form of ointments, creams or solutions.
If the patient suffers from severe itching, the dermatologist may prescribe antihistamines. They are usually taken for 10-15 days until the unpleasant symptom completely disappears.
Antifungal agents are used for damaged nails - 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, which eliminates the risk of side effects.
If external medications have no effect, systemic antifungals are prescribed.
The treatment regimen and dosage of medications are determined by the doctor. During treatment it is necessary to visit a podiatrist at least once a month.
Prognosis and prevention
If you consult a doctor in a timely manner, the prognosis of 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 the shoes after wearing them;
- Use an antifungal UV shoe dryer.
- Do not wear communal slippers when visiting.
- Don't try on shoes barefoot in a store;
- Use a personal towel for your feet.
- Use individual tools for nail care (tweezers, files);
- Wear shoes in the swimming pool or sauna;
- Monitor the diversity of your diet;
- Avoid stressful situations.
FAQ
How to cure athlete's foot?
To treat fungus on the legs, antifungal drugs are usually used, which are available in the form of creams, ointments and solutions. A dermatologist should select the most effective drug and determine its dosage.
Why do my feet itch?
One of the causes of itchy feet is mycosis of the feet, an infectious disease caused by dermatophyte fungi.