Mycosis of the feet (dermatophytosis) is an infectious disease caused by pathogenic or opportunistic fungi. In case of mycosis, the skin of the feet peels and itches strongly, 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 dermatophyte molds. A total of 43 types of dermatophytes are known, 30 of which lead to foot mycosis. Most often these are the fungi Trichophyton rubrum (90%), Trichophyton mentagrophytes and less often Epidermophyton. Much less often, mycosis of the feet is caused by fungi of the genus Candida and molds 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 connections 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.
Spread of foot mycosis
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 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. In men, the pathology occurs twice as often.
Among people over the age of 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 mycosis of the feet usually occurs in the family - by direct contact with the skin of an infected person. Cases of infection by sharing clothes, shoes and household items are also known.
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 the working hand. This condition is called two legs and one arm syndrome.
Causes of athlete's foot
Most often, mycosis of the feet 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 share 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 foot mycosis:
- violation of personal hygiene;
- shoe sharing (e. g. at bowling alleys, skate and ski rental shops);
- visiting public baths, pools, beaches;
- climatic features: the risk of disease is higher in countries with a subtropical and tropical climate - this is due to the 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 injuries to the toes due to flat feet, corns, calluses;
- non-observance of sanitary rules during pedicure;
- impaired blood supply to the legs;
- immunodeficiency conditions, including HIV;
- chronic dermatoses;
- obesity;
- diabetes;
- chronic venous insufficiency;
- taking certain drugs (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-hyperkeratous) 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 worried about moderate peeling of the skin between the fingers - the skin scales are abundant, thin and silvery in color. Then, when the disease spreads to the lateral and dorsal surfaces of the legs, a characteristic inflammatory rim 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 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 the bacterium Staphylococcus aureus is often observed.
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 painful itching and pain. Blisters with a dense coating 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 the 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 lower lateral surfaces of the feet, and even to 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, 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-dihidrotic form of foot mycosis is caused by the fungus Trichophyton rubrum (red trichophyton).
First, the skin between the fingers is affected. The process then spreads to the sole, dorsal and lateral surfaces of the foot and nail plates. Blisters and erosions appear on the skin, which are then covered with crusts. The skin becomes wet and may fester.
Eradicated form of foot mycosis
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 away. There may also be slight peeling on the feet and sides of the legs. Patients may ignore unpleasant symptoms, but still infect others.
Acute form of foot mycosis
The acute form of mycosis of the feet is the result of an exacerbation of a dyshidrotic or intertriginous (interdigital) form.
The disease begins acutely: a large number of blisters appear on the skin of the legs, and then on the legs. The skin swells. Next, nodules 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, becoming extensive weeping surfaces, often with a purulent discharge.
The disease is often accompanied by fever, worsening of the patient's general condition, and severe pain in the affected arms and legs. 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, skin rashes, localized mainly on the feet, 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 (top) is thick enough.
Often the nail plates are also involved in the process - onychomycosis develops.
Ulcerative form of foot mycosis
The ulcerative form (in foreign literature it is called deep) is one of the complications of foot mycosis caused by the addition of bacterial infection.
Extensive, deep purulent ulcers form on the feet. The patient experiences 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 doors 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 - purulent skin diseases (cellulitis, lymphangitis, phlegmon, 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 and reddens and blisters appear 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 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 conduct a dermatoscopy - an examination of the skin under magnification. In parallel with the examination, the specialist will collect anamnesis and question the patient about his lifestyle, quality of nutrition, household habits and care.
If you suspect mycosis, your doctor will order laboratory tests.
Examining skin scrapings will rule out or confirm a fungal infection.
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 it takes more time - 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.
A 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 the hematopoietic organs, allergic reactions and autoimmune diseases.
Also, before recommending antifungal therapy, the doctor may prescribe the patient a biochemical blood test - this test will determine the level of bilirubin and the liver enzymes ALT and AST. Such information will help the doctor choose the dose of the drug and minimize the risk of side effects.
Treatment of foot mycosis
The treatment of mycosis of the feet is carried out in two stages.
At the first stageIf there is acute inflammation, lotions are used: aqueous solutions of ammonium bituminous sulfonate, agents with antiseptic properties (Castellani liquid, 1% aqueous solution of brilliant green). After that, pastes and ointments are prescribed, which contain antifungal and glucocorticosteroid drugs.
In case of severe 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 antimycotic - 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 worried about severe itching, the dermatologist can prescribe antihistamines. It is usually taken for 10-15 days until the unpleasant symptom completely disappears.
In case of damage to the nails, 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, which eliminates the risk of side effects.
If external drugs do not work, systemic antimycotics are prescribed.
The treatment regimen and the dosage of the drugs are determined by the doctor. During treatment, it is necessary to visit an orthopedist at least once a month.
Prognosis and prevention
If you consult a doctor in 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 the 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 an anti-fungal UV shoe dryer;
- do not wear common 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. The dermatologist must 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 dermatophyte molds.