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 is very itchy, 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 mold. A total of 43 species of dermatophytes are known, 30 of which lead to mycosis in the feet. Most often these fungi are Trichophyton rubrum (90%), Trichophyton mentagrophytes and less commonly Epidermophyton. Mycosis of the feet is caused much less often 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 makes up the upper part of the skin of humans and animals. The skin is damaged.
Once the fungi are on the skin, they are directed to the most vulnerable places - the transitions between the cells of the epidermis. There they penetrate and begin to actively grow. However, fungi rarely penetrate deeper than the granular layer of the skin. Usually they are limited to the upper, keratinized tissues only.
Occurrence of mycosis in the feet
Mycoses of the skin, including mycoses of the feet, are found 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 occur in the skin most often - in approximately 30% of cases.
According to dermatologists, up to 20% of the adult population suffers from foot mycosis. Pathology is found twice as often in men.
Among people over 70, athlete's foot is found in almost every second patient - this is explained by the fact that the elderly 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 - through direct contact with the skin of an infected person. There are also known cases of infection when sharing clothes, shoes and household items.
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 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 mold (Scytalidium dimidiatum, Scytalidium hyalinum).
According to some studies, the share of dermatophytes in the structure of causative agents of mycosis of the feet decreases gradually. Candida fungi come to the fore.
Risk factors for the development of mycosis in the feet:
- violation of personal hygiene;
- shared shoes (for example in bowling alleys, skate and ski rental shops);
- visits to public baths, swimming pools, beaches;
- climatic characteristics: the risk of getting sick is higher in countries with a subtropical and tropical climate - this is due to increased humidity and ambient temperature;
- constantly wearing closed, tight shoes (this happens among military personnel, miners, workers in textile and metallurgical industries);
- frequent injuries to the toes due to flat feet, calluses, corns;
- non-compliance with sanitary rules during pedicure;
- decreased blood supply to the legs;
- immunodeficiency conditions, including HIV;
- chronic dermatoses;
- obesity;
- diabetes;
- chronic venous insufficiency;
- are taking certain medicines (systemic glucocorticosteroids).
Symptoms of mycosis in the feet
Symptoms of mycosis of the feet, as well as features in the treatment of the disease depend on its clinical form.
Squamous (squamous-hyperkeratotic) form of mycosis of the feet
In most cases, the causative agent of the squamous form of mycosis in the feet is the dermatophyte Trichophyton rubrum.
In the initial stage 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. Then, when the disease spreads to the lateral and dorsal surfaces of the feet, a characteristic inflammatory border 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 severe 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). Erosion and cracks often form. Many patients report itching, burning and pain.
Infection of the skin of the feet with dermatophyte fungi (usually Trichophyton mentagrophytes var. interdigitale) and the bacterium Staphylococcus aureus often occurs simultaneously.
Dyshidrotic form of foot mycosis
As a rule, the causative agent of this type of mycosis of the feet is Epidermophyton floccosum (flaky epidermophyton).
The dyshidrotic form of foot mycosis is usually more severe and is accompanied by painful itching and pain. Blisters with a thick covering form on the skin. By merging, they form large multichambered blisters, which, after opening, turn into moist pink erosions and then into brown crusts.
The disease is difficult to treat and often comes back.
A characteristic feature of the dyshidrotic form is damage to the arch of the foot, interdigital folds and skin on 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 the regional lymph nodes will be enlarged. Swelling of the foot appears, and 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-dyshidrotic form of foot mycosis is caused by the fungus Trichophyton rubrum (red trichophyton).
The skin between the fingers is affected first. Then the process spreads to the sole of the foot, dorsal and lateral surfaces and nail plates. Blisters and erosions appear on the skin, which are then covered with crusts. The skin becomes wet and may flare up.
Deleted form of mycosis of the feet
The deleted form has been 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. There may also be a little peeling on the soles and sides. Patients may ignore unpleasant symptoms, but they still infect others.
Acute form of mycosis in 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: a large number of blisters appear on the skin of the feet and then on the legs. The skin swells. Then knots form on the hands and lower third of the forearms.
After the blisters open, erosions occur, surrounded by remnants of loose skin. They merge and become extensive weeping surfaces, often with purulent discharge.
The disease is often accompanied by fever, worsening of the patient's general condition and sharp pains in the affected hands and feet. The lymph nodes in the groin and femur enlarge and become painful.
Vesiculobullous (inflammatory) form of mycosis in the feet
The inflammatory form of mycosis in the feet is usually identified by foreign authors, who often define it as acute. It can develop from a chronic interdigital form of dermatophytosis.
As a rule, the causative agent in the vesiculobullous form is the dermatophyte Trichophyton rubrum.
Main symptoms: severe itching, skin rash, localized mainly on the soles, on the bottom and on the sides of the fingers, on the back of the foot. Raised areas with blisters on the surface may occur. The bubbles can merge or remain unchanged for a long time - if the tire (top part) is thick enough.
Often the nail plates are 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. The patient experiences severe pain and, as a result, difficulty walking.
Complications of mycosis of the feet
Cracks and wounds on the skin that occur at the site of mycosis are the entry points 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 bacteria's resistance to drugs.
The most common complications of foot mycosis:
- allergic dermatitis of infectious and medicinal origin;
- pyoderma - pustular skin diseases (cellulitis, lymphangitis, phlegmon, osteomyelitis in the bones of the foot), which can lead to deep, long-lasting skin ulcers;
- plantar warts;
- microbial eczema is a chronic inflammatory disease where the skin itches and becomes red and blisters with liquid form on it;
- a general decrease in immunity and decreased microcirculation in the lower extremities (usually develops in patients with diabetes mellitus and varicose veins);
- spread of the disease to the skin of the hands and nail plates;
- deterioration of quality of life: in acute forms of mycosis, it is difficult to wear shoes, and lymphadenitis leads to fever and poor health.
Diagnosis of mycosis of the feet
A dermatologist-mycologist deals with the diagnosis and treatment of mycosis in the feet.
At the appointment, the doctor will assess the condition of the patient's nails, skin, mucous membranes and hair. He will perform a dermatoscopy - examine the skin under magnification. In parallel with the examination, the specialist will collect anamnesis and ask the patient about his lifestyle, quality of nutrition, household habits and care procedures.
If you suspect athlete's foot, 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 seeding or culture method allows you to get more accurate information about the cause of the disease, although it takes longer - usually a month.
Diabetes mellitus can significantly worsen the course of mycosis in the feet and lead to serious complications. Complex investigations can rule out or confirm this diagnosis.
A complete blood count helps assess the patient's general condition.
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.
Before recommending antifungal treatment, the doctor may also prescribe the patient a biochemical blood test - this test will determine the level of bilirubin and liver enzymes ALT and AST. Such information will help the doctor to choose the dose of the drug and minimize the risk of side effects.
Treatment of mycosis in the feet
Treatment of mycosis of the feet is carried out in two phases.
On the first phaseIf 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). Pastes and ointments containing antifungal and glucocorticosteroid drugs are then prescribed.
In case of severe weeping (in the acute phase) and the addition of a 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 antifungal - 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 bothered by severe itching, the dermatologist can prescribe antihistamines. They are usually taken for 10-15 days until the unpleasant symptom completely disappears.
When the nails are damaged, 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 medicine does not give an effect, systemic antifungal agents are prescribed.
The treatment regimen and the dosage of medicines 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 time, the prognosis for mycosis of the feet is favorable: most patients who are treated with antifungal drugs get rid of the disease forever.
To prevent mycosis, you must protect your feet and hands from irritating and traumatic factors and strengthen your immune system.
Measures to prevent onychomycosis:
- change socks every day or more often if your feet are sweaty or wet;
- air or dry shoes after use;
- use an antifungal UV shoe dryer;
- Do not wear shared slippers when visiting;
- don't try on shoes in a store with bare feet;
- use a personal towel for your feet;
- use individual tools for nail care (tweezers, files);
- wear shoes in the pool or sauna;
- monitor the diversity of your diet;
- avoid stressful situations.
FAQ
How to cure athlete's foot?
For the treatment of fungus on the legs, antifungal drugs are usually used, which are available in the form of creams, ointments and solutions. A dermatologist should 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 mold.