Tinea Pedis: Diagnosis and Treatment


Tinea pedis (athlete’s foot) is a common skin infection of human feet that is caused by a fungus. Patients present with itching, scaling, and redness. Blisters are also noted in some rare cases. Although the skin disease may affect any part of human feet, the fungus often thrives between the toes. In addition, the infection affects the skin as well as the hands (Canavan & Elewski, 2015; Ilkit & Durdu, 2015). This discussion highlights several aspects of the disorder such as the incidence and prevalence, pathophysiology, physical assessment and examination, treatment plan founded on reliable evidence and client education (teaching), and follow-ups/evaluation.

Incidence and Prevalence

Globally, tinea pedis affects about fifteen percent of the population and about one-fifth of adults. However, it is common among persons who wear occlusive footwear such as vinyl shoes. Individuals who frequently wear shoes are more affected than those who go barefoot (Ilkit & Durdu, 2015). Regions and nations that have relatively high incidence and prevalence rates are those whose inhabitants wear shoes; thus, the disease is often described as “a penalty of civilization” (Ilkit & Durdu, 2015). Notably,the infection is more distributed in men than in women.

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Pathophysiology Based on Advanced Practice

Dermatophytes that are associated with tinea pedis are keratinophilic fungi that can invade keratinized tissue of the skin. Once these microbes gain access into the skin, they reside in the stratum corneum, which is a portion of the epidermis. Notably, they rarely go beyond the surface of the epidermis as well as its appendages (Ilkit & Durdu, 2015). The thriving of these pathogens is supported by humidity on the surface of the skin. Research has demonstrated that the establishment of tinea pedis only occurs in moist environments of the human body (Ilkit & Durdu, 2015). If there is a proliferation of the dermatophytes in the skin layer consisting of basal cells, the tissue reacts to the infection by epidermal thickening, which can be accompanied by scaling and itching.

Physical Assessment and Examination

Physical assessment starts when a patient presents with the signs of tinea pedis, and a doctor visually inspects the skin to identify obvious symptoms like itching between the toes. Physical examination may also reveal mucocutaneous manifestation characterized by vesicles and blisters, which are both filled with fluid. Vesicles are about 5-10 mm, while bullae are larger than 10 mm (Canavan & Elewski, 2015). An examination can be conducted using direct microscopy that involves a potassium hydroxide (KOH) test. This involves testing of a skin scraping and it may reveal several branches of hyphae of the fungus. The ulcerative condition associated with the disease is typified by macerated lesions that have scaly borders (Canavan & Elewski, 2015). It is essential to state that maceration involves softening and disintegration of the skin as a result of prolonged exposure to high levels of humidity.

Treatment Plan and Patient Education

Antifungal medications such as allylamines and azoles may be applied to the affected areas, but athlete’s foot may resolve without treatment in about thirty to forty percent of cases. Antifungal agents can be in the form of sprays, gels, or creams. Topical application of creams having antifungal agents once daily for fourteen days has been demonstrated to be effective in most cases (Lipner & Scher, 2015). In addition, research has shown that conventional treatment could be an effective way of handling the disease (Canavan & Elewski, 2015). This management involves thorough washing of the feet two times daily, followed by the application of the topical medications. Since the outer skin layers are destroyed by the infection and could be susceptible to reinfection, this treatment should continue until a new cell cover replaces the affected epidermis.

Patients should be educated to use the medications in the right way. For example, a doctor can demonstrate how the drugs should be applied to the skin. Later, a patient can be requested to show what he or she has learned (Lipner & Scher, 2015). Moreover, a patient suffering from tinea pedis should be taught how he or she can ensure that feet are clean.

Follow-Ups/Evaluation

Follow-ups would be essential in evaluating the outcomes of treatments that are offered based on evidence in the management of a chronic or acute tinea pedis case. A doctor should advise his or her clients suffering from athlete’s foot to return for assessment when the initial treatment does not seem to be successful or if they experience frequent recurrences (Lipner & Scher, 2015). During such visits, a healthcare practitioner should assess whether a patient has been adhering to the treatment regimen.

Conclusion

In summary, tinea pedis mostly affects the toes of human beings. More men than women are affected by the disease, which is manifested through scaling, itching, and redness of the skin. Pathogenesis of athlete’s foot involves thickening of the epidermis due to the disintegration of basal cells. Physical examination and assessment are critical to diagnosing tinea pedis. Treatment of the infection involves the topical application of antifungal agents such as azoles. Follow-ups of patients on treatment help healthcare providers to assess the effectiveness of the management regimens.

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References

Canavan, T. N., & Elewski, B. E. (2015). Identifying signs of tinea pedis: A key to understanding clinical variables. Journal of Drugs in Dermatology, 14(10), 42-47.

Ilkit, M., & Durdu, M. (2015). Tinea pedis: The etiology and global epidemiology of a common fungal infection. Critical Reviews in Microbiology, 41(3), 374-388.

Lipner, S. R., & Scher, R. K. (2015). Management of onychomycosis and co-existing tinea pedis. Journal of Drugs in Dermatology,, 14(5), 492-494.

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