Tinea Pedis (interdigital macerated type)

Diagnosis: Tinea Pedis (interdigital macerated type)

The webspace between the 4th and 5th toes is hyperkeratotic and macerated.

Clinical Presentation

The webspace between the 4th and 5th toes is hyperkeratotic and macerated.

Clinical History

Submitted by Alaa Saad. Originally posted October 12, 2010.

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, interdigital, macerated, type, alaa saad