tinea pedis

Diagnosis: tinea pedis

white moist macerated skin between the web space of 4th.&5th. toes of the right foot.

Clinical Presentation

white moist macerated skin between the web space of 4th.&5th. toes of the right foot.

Clinical History

Submitted by sameh elseiny. Originally posted March 26, 2011.

Treatment

See case discussion.

Differential Diagnosis

• Contact dermatitis • Dyshidrotic eczema • Psoriasis (palmoplantar) • Pitted keratolysis • Erythrasma • Juvenile plantar dermatosis • Secondary syphilis (plantar)

Key Learnings

• Most common dermatophyte infection — T. rubrum most common causative organism • Three clinical patterns: interdigital (most common), moccasin (chronic, T. rubrum), vesiculobullous (inflammatory) • "Two feet, one hand" syndrome: bilateral tinea pedis + unilateral tinea manuum — characteristic pattern • Interdigital tinea pedis is a major risk factor for lower extremity cellulitis • KOH confirms diagnosis — roof of vesicle or leading edge of scale • Moccasin type requires systemic antifungals — topical treatment alone is inadequate • Treat tinea pedis to prevent recurrent cellulitis in patients with venous insufficiency

Tags: tinea, pedis, sameh elseiny