Treatment of epidermophytosis of thick black nails. Athlete's foot. The pathogenesis of the disease is due to

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Athlete's foot represents fungal infection (mycosis skin, or dermatomycosis), affecting the skin and its appendages (hair and nails). The infection is caused by fungi epidermophytons or trichophytons. Athlete's disease has a chronic, long-term course and is transmitted by contact exclusively from person to person. Fungal treatment infections carried out with various drugs that have an antifungal effect.

General characteristics of the disease

By the term "epidermophytia" (epidermophytia), modern doctors and scientists mean a group of fungal infections of the smooth skin of the body, feet, hands, or, in rare cases, nails. The scalp is not affected by epidermophytosis. In general, the term "athlete's foot" consists of two words - "epidermis" and "phytia". The epidermis is the uppermost, outer layer of the skin, and phytia is the collective name for pathogenic fungi that can infect the epidermis, causing a long-term and sluggish chronic inflammatory process in it. Thus, the general meaning inherent in the term “athlete's foot” is a fungal infection that affects the outer layer of the skin (epidermis).

The fungi that cause athlete's foot are contagious and widespread in the environment. Therefore, this infectious disease is also recorded quite often in all parts of the world and countries of the world. Men are more susceptible to infection with athlete's foot compared to women, as a result of which this infectious disease more often develops in the stronger sex. In addition, there is evidence that urban residents are more likely to suffer from epidermophytosis than the rural population. Children under 15 years of age very rarely suffer from athlete's foot, and adolescents aged 15–18 years suffer from this infection more often than children, but less often than adults.

The most susceptible to epidermophytosis are people who are exposed to high temperatures and high humidity for a long time and often, as well as those individuals whose skin is constantly sweating, damaged or macerated. This means that epidermophytosis most often affects people who constantly visit swimming pools, saunas and beaches (including employees of baths, saunas, swimming pools, beaches, swimmers, etc.), and who neglect the rules of personal hygiene (for example, walking without personal slippers, use of shared washcloths, towels in showers, etc.). In addition, professional athletes, workers in hot shops and coal mines often suffer from epidermophytosis, since their skin constantly sweats. Among professional athletes, swimmers, workers of baths, showers, swimming pools, saunas, hot shops and coal mines, the incidence of epidermophytosis, according to a number of researchers, reaches 60 - 80%.

Athlete's foot can occur in two main clinical forms - athlete's foot and inguinal athlete's foot. Athlete's inguinal is a form of infection that affects smooth skin mainly in large folds, such as the inguinal, thigh, axillary, intergluteal fold, inner thighs, folds under the mammary glands in women, folds on the abdomen and waist in obese people, and also the interdigital spaces on the hands and feet. Fingernails and toenails are extremely rarely affected by athlete's foot. Since the most common foci of fungal infection are located in the inguinal folds and on the inner surface of the thighs, this form of epidermophytosis is called “groin”.

Athlete's foot is a form of infection that affects the skin of the arch and interdigital spaces of the feet. In addition, with athlete's foot, the infection often involves the nails. Because this form of infection affects the skin and/or nails of the foot, it is called athlete's foot. The infection can occur in various clinical forms.

Athlete's foot and inguinal athlete is caused by various types of pathogenic fungi. Thus, athlete's foot is caused by the fungus Epidermophyton floccosum, also called Epidermophyton inguinale Sabourand (pictured on the right). Athlete's foot is caused by the fungus Trichophyton mentagrophytes, a variant of interdigitale. However, both fungi have similar properties, affecting primarily the epidermis, as a result of which the infections caused by them are combined into one large nosological group (disease) called “athlete's foot.”

At athlete's foot inguinal lesions are usually located in the armpits, on the inner thighs, pubis, in the folds of the mammary glands or in the interdigital spaces of the feet or hands. First, small scaly, inflamed spots, colored red, the size of a lentil grain, appear on the skin. Gradually, the spots increase in size, forming rather large oval lesions, the surface of which is red, macerated, covered with bubbles and crusts. The edge of the lesions is raised above the surface of the surrounding skin due to edema. As the infection continues, the foci merge with each other, forming fields the size of a palm. In the central part, the lesions turn pale and sink, and along the edges there is a ridge of exfoliating epidermis. The lesions are itchy. As a rule, athlete's foot develops abruptly, with the simultaneous appearance of several small red spots. After which the disease becomes chronic and can last for years. After transition to the chronic stage, athlete's foot occurs with alternating periods of exacerbations and remissions. Remissions are more or less quiet periods during which the lesions do not increase in size, do not itch and practically do not bother the person. And during periods of exacerbations that occur after profuse sweating, the lesions begin to quickly increase in size, turn red and itch.

At athlete's foot The skin of the foot and sometimes the nails are affected. Nails are not always involved in the pathological process. Depending on exactly how the disease progresses and which areas of the skin of the foot are affected, five clinical types of athlete's foot are distinguished: erased, squamous-hyperkeratotic, intertriginous, dyshidrotic and nail. The listed types of athlete's foot are quite arbitrary, since often the disease occurs in the form of a combination of clinical signs of two, three or four varieties.

Erased form Athlete's foot is characterized by the appearance of mild peeling in the arch of the foot. The area of ​​peeling is usually located in an area of ​​slightly reddened skin. Areas of peeling can be both small and impressive in size, but are always limited to the foot. In some cases, a slight itching is recorded in the area of ​​peeling, which then appears and then disappears. Due to the insignificant severity and low degree of discomfort of clinical manifestations, the erased form of athlete's foot very often goes unnoticed. That is, a person simply does not attach importance to the peeling and slight itching that appears on the skin of the foot, considering this to be some kind of temporary phenomenon caused by irritation, abrasion or severe sweating of the foot in shoes. However, a distinctive feature of the erased form of epidermophytosis is that the disease begins with lesions of the skin of only one foot, and over time it always affects the second leg. The erased form of athlete's foot can turn into dyshidrotic, and dyshidrotic, on the contrary, often ends in erased.

Squamous-hyperkeratotic form Athlete's foot is characterized by the development of dry, flat papules and plaques with thickened skin, colored bluish-red. Typically plaques and papules are located on the arches of the feet. On the surface of papules and plaques (especially in their central parts) there are flaky layers of grayish-white scales. The formations are clearly demarcated from the surrounding skin, and along their perimeter there is a ridge of exfoliating epidermis. Over time, such formations can merge with each other, forming large lesions covering the entire sole and lateral surfaces of the foot. If plaques and papules initially formed in the interdigital spaces, then over time they can spread to the lateral and flexor surfaces of the fingers, as a result of which the latter acquire a whitish-gray color. In addition to papules and plaques, athlete's foot can cause yellow calluses with cracks on their surface. Itching, soreness and dry skin develop in the area of ​​the formations.

Intertriginous form athlete's foot is characterized by the appearance of lesions in the interdigital folds. Most often, foci of fungal infection appear in the folds between the fourth and fifth toes and, somewhat less frequently, between the third and fourth toes. In rare cases, the fungal infection spreads to other spaces between the toes, to the back of the foot, or to the flexor surfaces of the toes. The lesions appear as cracks in the skin, surrounded by a whitish, flaking epidermis. In addition, weeping (liquid is released) and itching appears in the area of ​​the cracks. With large cracks, pain occurs. As a rule, the intertriginous form of athlete's foot develops from the squamous form, but in some cases it can appear independently.

Dyshidrotic form epidermophytosis is characterized by the formation of a lesion in the arch of the foot. The lesion is a group of bubbles of various sizes, ranging from the size of a pinhead to a pea. The bubbles are covered with a tight lid. Over time, the bubbles merge with each other, forming large bubbles consisting of separate chambers. In place of such blisters, eroded surfaces (areas of red, inflamed skin, reminiscent of a fresh abrasion) are formed, limited by a raised ridge of macerated (swollen and edematous) skin. The pathological process from the arch of the foot can spread to its outer and lateral surfaces. There is constant itching and soreness in the affected area. Usually the contents of vesicles and multi-chambered blisters are transparent, but when a bacterial infection is attached, they become cloudy. In this case, when the blisters are opened, pus is released. After the blisters open and erosions form, the inflammatory reaction gradually subsides, the damaged skin epithelializes (heals), and new blisters do not form, resulting in a period of remission. During the period of exacerbation, bubbles appear again in a person, merging into large multi-chamber bubbles, which eventually burst, and in their place eroded surfaces form. After the erosions heal, a period of remission begins again. The dyshidrotic form of athlete's foot can last for years, with relapses alternating with remissions. Relapses are most often observed in spring and summer, when the skin of the feet sweats more. As a rule, the skin of only one foot is affected; the infection process rarely spreads to the second foot.

Nail shape athlete's foot (athlete's foot nails) is characterized by damage to the nail plates. First, yellow spots and stripes appear at the free edge of the nail, then the entire nail plate thickens, turns yellow, breaks and crumbles, and loose horny masses accumulate under it. Sometimes the nail plate becomes thinner and falls away from the nail bed, that is, onycholysis occurs (melting of the nail). The nails of the first and second toes are most often affected. But fingernails are never affected by athlete's foot.
Cause of athlete's foot(both inguinal and foot) is a pathogenic fungus that settles on the skin. However, just getting the fungus on the skin is not enough to cause the disease to develop. For epidermophytosis to appear, in addition to the fungus getting on the skin, it is also necessary to have predisposing factors that make the skin vulnerable to the pathogenic microbe. If there are no predisposing factors, then athlete's foot does not develop, even if the fungus gets on the skin in large quantities, since its protective properties do not allow the pathogenic microorganism to penetrate the tissue and provoke an infectious-inflammatory process. If the skin is damaged under the influence of predisposing factors, then contact with the fungus on the skin will lead to the development of epidermophytosis.

For athlete's foot, predisposing factors are sweating of the feet, flat feet, compression of the feet by tight shoes, abrasions, and diaper rash on the skin of the feet. In addition, doctors identify a number of diseases as predisposing factors for athlete's foot, such as angiopathy, acrocyanosis, ichthyosoform skin lesions, as well as deficiency of vitamins and microelements.

Both clinical forms of athlete's foot (both inguinal and foot) are transmitted only from sick people to healthy people when using common objects that may contain pathogenic fungi. That is, a patient with epidermophytosis uses any object on which pathogenic fungi remain. And if a healthy person uses the same item after a short period of time, he will transfer the fungi to his own skin, as a result of which he may become infected with epidermophytosis. Thus, infection with inguinal athlete's foot most often occurs when using shared washcloths, towels, linen, oilcloth, bedpans, sponges, thermometers, etc. And infection with athlete's foot most often occurs when using shared rugs, bedding, flooring, basins, benches, as well as when wearing shoes, socks, tights, stockings, etc. together. Since all the objects through which epidermophytosis infection most often occurs are usually used in public baths, saunas, swimming pools or on beaches, infection with the disease usually occurs when visiting these places.

Blisters and cracks on the skin of the extremities. Causes and treatment

In dermatology, athlete's foot and hands occupy a special place. A fifth of known “fungal” diseases fall under this diagnosis.
Content

The pathogenesis of the disease is due to

• Increased sweating of the feet
• Injuries
• Wearing narrow and tight shoes
• Physiological structure of narrow interdigital spaces
• Disturbances in the functioning of the nervous system
• Disruption of the circulatory system in the extremities
• Metabolic problems
• Flat feet

More often, the fungus affects the skin between the 5th and 4th or 4th and 3rd toes. First itching appears, and then cracks. Blisters appear on the surface of the foot, and the skin around them turns red. There are times when the arch of the foot only turns red. Damage to the nail plates of the 1st and 5th toes often occurs. Their color fades, turning yellowish or gray-yellow. Later thickening is observed. Nails begin to crumble.

When does the risk of fungal infection increase?

• When visiting the bathhouse
• When using showers in common areas
• When swimming in pools
• When wearing someone else's socks, stockings, tights
• Frequent use of rubber shoes

The disease is more common in countries with hot climates and in children. It is dangerous because harmful fungal bacteria enter the body through diseased skin: ulcers form, causing pain and discomfort, and the temperature often rises. Fungi that live in the human body for a long time weaken the immune system. The result may be the appearance of allergic foci, creating the risk of eczema.

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The diagnosis is made when the following signs are present

• Blisters on the skin
• Flaky soles and sides
• Cracks in the skin in the folds between the fingers
• Stripes and yellow spots on the nail plate
• Thickened furrows on the skin

Fungal infection does not always manifest itself with all of the listed symptoms. The most common concern about the erased form of the disease is itching and flaking in the folds between the fingers. This is the initial stage of the disease, which later takes on more active forms.

With athlete's foot, the first symptoms of the disease appear on the soles of the feet, and then the rashes spread to the hands. Signs of eczema often appear the other way around or at the same time.

The appearance of epidermophytosis is most often localized on the surface of the fingers on the palm or side. Eczema most often affects the dorsum of the skin of the hands and feet.

Symptoms of eczema appear on the soles of the feet in the form of lesions, often symmetrical, which rarely occurs with athlete's foot.

Treatment methods

If you notice signs of a fungal infection, you should seek medical help. After an examination, a dermatologist will order tests, based on which he will confirm the diagnosis and prescribe treatment with antifungal agents.

In severe cases of the disease with many cracks, erosion and ulcers, warm baths with potassium permanganate are practiced. During this procedure, large scales are separated from the skin surface. Then cream is applied to dry skin.

If there is increased keratinization of the skin, you must first remove the horny thickenings using salicylic petroleum jelly at a 5-15 percent concentration. It is applied in the morning and at night. Skin scales are removed using pumice.

Athlete's feet and hands are caused by one type of fungal infection. Therefore, their treatment is practically the same. Its main principle is to relieve the inflammatory process, influence bacteria with antifungal agents, improve the blood supply to the affected areas of the skin, and strengthen the immune system. Medicines are used in the form of ointments, creams, gels, tablets, solutions for administration into a vein or muscle.

To treat allergies and infections that accompany the course of the disease, at the onset of the disease, antibacterial agents against infection and corticosteroid ointments against allergic symptoms are prescribed.

The disease occurs with remissions and relapses. The full course of treatment is at least four weeks. But if the conditions that caused the appearance of athlete's foot do not change, then the disease may return.

For the purpose of prevention it is necessary

1. Lubricate the soles and interdigital folds daily with iodine at a 1-2 percent alcohol concentration for 3-4 weeks.
2. Disinfect stockings, socks, tights,
3. Disinfect shoes by placing newsprint or cotton wool in them for two days, after soaking them in formalin at a 40% aqueous concentration,
4. Treat sweaty feet
5. Wear rubber slippers in public places.

According to Dr. Neil Kramer. podiatrist from Pennsylvania, you need to keep your shoes dry and clean. He advises treating the inside of your shoes with antifungal powders or sprays. There are a lot of them sold in pharmacies today.

If you have athlete's foot, after bathing in the shower or bath, you should first dry the groin area, then the legs. Also, put on socks first and then underwear. This will prevent the infection from spreading to the groin area.

Treatment with drugs must not be interrupted until cure, because even after the symptoms disappear, the fungus lives on the skin for many days.

Green pharmacy

In the course of experimental and clinical studies, antimycotic properties were identified in more than a thousand plants. Some medicines are based on fir, eucalyptus, bird cherry, and mustard needles. For example, lutenurin is obtained from yellow egg capsule, novoimanin is obtained from St. John's wort, etc. Traditional healers have many of their own recipes. In particular, they recommend:

• Lubricate the affected areas of the skin with crushed black radish seeds, the powder of which is diluted to a thick consistency with water.
• Lubricate the reddened surface with milkweed juice twice a day.
• Mix crushed garlic with butter in a 1:1 percentage ratio. Treat reddened skin and nails with this homemade cream.
• Pour 10 parts of birch buds with 1 part of vodka. After a week, strain and lubricate your feet and nails.
• Apply grated fresh onions to the sore skin surface.
• Lubricate the skin with fig essential oil.
• Mix carrot juice and vinegar one tablespoon at a time. Wrap a piece of cotton wool around a stick, wet it and lubricate the affected skin.
• Apply orange juice of fresh celandine to areas of infection for half an hour.
• Rub baking soda moistened with water into the folds of the skin between your fingers.
• Mix crushed peppermint leaves with salt. Apply between fingers for one hour.
• Apply a solution of alcohol, vinegar essence (two teaspoons each) and glycerin (one teaspoon) to the nail affected by the fungus every day at night.
• Lubricate affected nails with iodine daily.
• Apply fir oil and hold for at least 25 minutes,
• Soak your feet in an infusion of crushed clematis leaves.
• Keep your hands and feet in warm water with salt for 10-15 minutes.
• Lubricate the skin of the feet and nails with almond, strawberry, cherry, and dogwood essences.
• Use tar to lubricate the affected surface.
• Walk barefoot through the dew every morning for at least half an hour.
• Drink tea and garlic infusions. Symptoms of athlete's foot disappear after 4-5 days.
• To strengthen the immune system, take aloe juice tinctures daily.
• Rub lemon juice onto the affected skin.
• Use lavender oil to lubricate the affected area of ​​skin.
• Pour 70 mg of talc and 20 mg of boric acid powder into socks.

A common fungal infection of the toenails, manifested by the appearance of yellow stripes or spots, and then diffuse yellowness of the entire nail plate, its thickening, deformation and increased fragility. Diagnostic measures for epidermophytosis of the nails include examination of the affected nail plate and microscopy of a scraping taken from its surface. The disease is treated by dermatologists, podologists and mycologists. It includes removal of the nail plate, postoperative treatment and application of bandages with antifungal ointments and keratolytic agents to its bed.

Along with pityriasis versicolor, trichophytosis, favus, microsporia, coccidioidomycosis and rubromycosis, epidermophytosis of the nails is a fungal disease of the skin and its appendages. It is one of the most common mycoses. The causative agent of athlete's foot, Trichophyton mentagrophytes, can also cause inguinal athlete's foot and skin lesions on the feet. Infection of nails occurs through contact through socks, shoes, shower mats, etc. Most often, infection occurs in bathhouses, swimming pools, and gyms.

Athlete's foot disease occurs mainly among adults. Cases of its development in children under 15 years of age are extremely rare in dermatology. This pathology is more common among urban residents than among rural residents.

Symptoms of athlete's foot nails

Manifestations of athlete's foot nails begin at the free end of the nail, where stripes and spots of yellow color appear. Over time, they increase in size and spread to most of the nail plate. If the process is accompanied by thickening of the nail, its curvature and increased fragility, then they speak of a hypertrophic version of epidermophytosis of the nails. In this case, the nail plate affected by the fungus begins to fade and crumble, its free edge looks bitten, and underneath there is an accumulation of horny masses - subungual hyperkeratosis. In other cases, thinning of the nail plate and its subsequent rejection may be observed - an onycholytic variant of epidermophytosis of the nails.

Most often, the fungus affects the nail plates of the 1st and 5th toes. Some authors believe that this localization is associated with greater trauma to the nail plates of the extreme fingers when walking. A distinctive feature of athlete's foot nails is the intactness of the fingernails. The disease is characterized by a chronic and long-term (10 or more years) course. Most often, exacerbations occur in the hot summer season.

In about a third of patients, athlete's foot nails are observed against the background of athlete's foot, characterized by red, swollen, scaly lesions on the skin, in some cases - blistering rashes.

Diagnosis of athlete's foot nails

If yellowness and deformation of the nail plates are detected, the patient should consult a dermatologist, mycologist or podologist. Characteristic changes in the nails and their localization, as well as the absence of lesions on the nail plates of the hands, will allow the doctor to immediately diagnose epidermophytosis of the nails.

To confirm the fungal origin of the disease, it is necessary to conduct a microscopic examination of a scraping for fungi taken from the affected nail plate. With epidermophytosis of the nails, in the scraping scales, under a microscope, branching filaments of mycelium of varying thickness are revealed, periodically breaking up into square or round spores.

Treatment of athlete's foot nails

When diagnosing athlete's foot, as a rule, a decision is made to remove the infected nail plate. After surgery, the bed of the removed nail is treated with aniline dyes (fucorcin, brilliant green) and fungicidal agents (Castellani or Krichevsky liquid, nitrofungin). Dressings are applied with Wilkinson's ointment, antifungal ointments with clotrimazole, undecylenic acid, miconazole, and in the case of hyperkeratosis - with keratolytic drugs.

And we also have

Athlete's foot is a lesion of the upper layers of the skin and nail plates by the fungus Trichophyton mentagrophytes, but often the symptoms of the disease are caused by completely different pathologies.

To a greater extent, the disease affects the adult population of the planet, and it manifests itself less often in rural residents than in city dwellers.

Factors

Athlete's foot and hand are easily transferred from one person to another. The disease spreads in public places such as saunas, swimming pools, baths and gyms.

The main methods of transmission are:

• contact of bare feet with an infected surface;
• close contact with affected areas;
• trying on and wearing someone else's shoes, socks, stockings;
• sanitary and hygiene supplies - soap, clippers, wire cutters, washcloths, sponges, towels.

A specific fungus is not always the main pathogen. The lower extremities are affected by chronic arterial disease, venous insufficiency, and deep vascular thrombosis.

And also for disorders of glucose absorption, multiple damage to peripheral nerves, disruption of the autonomic nervous system and weak immunity. Important reasons for the manifestation of the disease are: increased sweating of the feet, narrow feet, the presence of flat feet, alkaline reaction of sweat.

Types and signs

To find out what kind of disease this is, it is worth taking a closer look at its types and identifying the symptoms inherent in epidermophytosis.

Dermatologists identify four main forms that affect the feet:

• Intertriginous - This type affects the spaces of the little, ring and middle fingers, as well as their folds. Swelling, erosion, cracks, and weeping wounds form. A strong burning sensation and peeling of white crusts of the skin were noticed.
• Squamous - considered a dangerous form of mycosis. As shown in the photo above, it is characterized by the formation of flatness on the arches of the feet and lateral surfaces. Papules have clear outlines and sometimes resemble plaques typical of psoriasis. Often, lesions appear in areas. This type is characterized by intermittent itching.
• - Forms on the soles, arches of the feet, fingers and their folds. They appear on the epidermis, subsequently merging and acquiring a multi-chamber structure. The affected areas are itchy and painful. After opening, the skin turns red-pink.
• Athlete's foot is a type of complication that develops as a result of the first three forms. , exfoliate, thicken, . Often, complete or partial rejection of the nails occurs. The thumbs and little fingers are mostly affected.

A separate type is erased epidermophytosis. This is a mild form of the disease that manifests itself in the initial stages. Minor peeling of the skin and rare cracks between the fingers are observed.

Athlete's foot develops in children for the same reasons as in adults. It is mainly active in spring and summer, and may be quiet in winter.

Diagnosis of pathology

The procedure is performed by a dermatologist or mycologist. To find out what type of pathogen, particles are scraped off from the diseased nail and skin. Next, the selected material is soaked in alkali and examined under a microscope.

If fungal threads are found in it, a positive diagnosis is made. The result will not be correct if the peelings were taken from a wet area.

Therapy

After making a diagnosis, the question is: “how to treat epidermophytosis so that it goes away in a short time and there is no relapse?” becomes relevant. Doctors claim that “the pathology does not require hospitalization; therapy is carried out at home.”

1. In the squamous form, scales and hardened layers are first removed from the affected areas to free the skin from dead tissue. For this, a special consistency is prepared, which includes: salicylic and lactic acid, as well as white petroleum jelly. The resulting ointment is applied to areas of inflammation, covered with a compress and kept for 48 hours. Then the exfoliated epidermis is removed. The next stage consists of local use of antimycotic creams, ointments and sprays, including: Ketoconazole, Naftifine, Terbinafine. It is recommended to use the drugs until the signs of the disease disappear.
2. The first step in the treatment of dyshidrotic and intertriginous legs is the removal of inflammatory processes, swelling and elimination of weeping. First, bubbles, if they have formed, are pierced with a sterile needle. Afterwards, lotions containing solutions of resorcinol, chlorhexidine, ethacridine lactate are applied to the affected areas of the epidermis 2 times a day. If the inflammation is pronounced, it is recommended to additionally use a hormonal ointment, for example, Hydrocortisone, for a short period of time. The next step will be the local use of antifungal agents, the most common of which are: Exoderil, Ketoconazole, Befonazole.
3. For erased it is enough to use antimycotic drugs until complete recovery.
4. For athlete's foot, antifungal agents are used externally and internally, as this is a more severe degree of the disease. Among them: “Irunin”, “Orungal”, “Fluconazole”, “Terbinox”. The duration of treatment depends on the location of the affected areas. If fingernails are affected, the course of therapy will be six to twelve weeks. And if you are on your feet, taking medications will last for six months. Before starting treatment, it is recommended to remove diseased nails or at least file off the damaged layer daily and treat it with iodine, salicylic acid, and antifungal varnishes.

Home Remedies

In addition to medications, you can add treatment with folk remedies. Compresses and baths made from a decoction of celandine flowers, chamomile, St. John's wort, and eucalyptus leaves have a soothing and antifungal effect.

Disinfect the affected areas with apple cider vinegar or calendula tincture. It will be effective to lubricate with sea buckthorn or tea tree oil, which eliminate inflammation and are antiseptic.

Precautionary measures

Athlete's foot occupies a special place in dermatology. This fungal disease is common in all countries of the world. The largest percentage of cases are made up of certain groups of the population: bathhouse workers, athletes, workers in hot shops, miners, etc. In cities, pathology is more common than in rural areas. Children rarely get this disease.

In the article we will talk about athlete's foot, consider the forms of this disease, and talk about treatment methods.

Causes

The development of the disease is associated with infection with the fungus Trichophyton mentagrophytes. It is also a causative agent in the case of nail or inguinal athlete's foot. From sick people to healthy people, the fungus is transmitted by contact, usually in public swimming pools, baths, saunas, showers, gyms, as well as through common objects.

In a sick person, fungal spores are found in the stratum corneum of the epidermis, the scales of which exfoliate abundantly in case of athlete's foot. In this way, the fungus ends up on shower mats, shoe insoles, rugs and washcloths, where it persists for a long time, especially in humid and warm climates.

Infection with Trichophyton mentagrophytes does not lead to athlete's foot in all people. The occurrence of the disease is favored by trophic disorders in the lower extremities, which occur with varicose veins, accompanied by chronic venous insufficiency, diabetes mellitus, deep thrombosis of peripheral vessels, atherosclerosis, vegetative-vascular dystonia, polyneuropathy. Narrowed interdigital spaces, excessive sweating of the feet, alkaline sweat reaction, and flat feet can also contribute to the development of athlete's foot.

Types of disease

In modern clinical dermatology, different forms of athlete's foot are distinguished. There are five of them in total:

• squamous;
• intertriginous;
• erased;
• dyshidrotic;
• nail

These forms can transform into one another or be combined with each other. Let's talk about each variety in more detail.

Squamous form

With this variant of the disease, the lesions can be both extensive and small. Squamous athlete's foot (see photo below) is characterized by peeling and slight redness on the arches. Sometimes patients complain of mild and intermittent itching. From an epidemiological point of view, this form of the disease is the most dangerous, since it can occur unnoticed by a person, but for others it acts as a source of infection.

With exacerbation, squamous epidermophytosis can turn into dyshidrotic, and, on the contrary, the dyshidrotic form can result in squamous. The pathology always first affects one side, but over time it spreads to the second.

Intertriginous form

It often develops when there is already a mildly expressed squamous athlete's foot. The photo below demonstrates that the fungus affects the interdigital folds, usually between the fourth and fifth fingers, less often between the rest. The pathological process in some cases can spread to the dorsum of the foot and the flexor surfaces of the fingers. Cracks form in the interdigital folds, surrounded along the periphery by a peeling whitish stratum corneum of the epidermis.

Intertriginous athlete's foot causes the following symptoms: weeping, itching, pain when erosions appear. The pathological process is long-term, it can subside in winter, and in summer it can worsen again. Loosening of the stratum corneum and the presence of cracks create optimal conditions for the penetration of streptococcal infections, leading to the development of thrombophlebitis and chronic erysipelas of the legs.

Dyshidrotic form

The disease is manifested by the appearance of blisters in the foot area, which, as a rule, are small in size and located in groups. Over time, these bubbles merge with each other and form multi-chamber formations. After opening, an eroded surface with a border of macerated epidermis on the periphery remains in their place. Then the pathological process spreads to the outer lateral surface of the foot, creating a single focus of infection.

Dyshidrotic athlete's foot is manifested by itching and pain in the affected areas. A secondary infection may occur; in this case, the contents of the blisters become cloudy, pus is released upon opening, and lymphadenitis and lymphangitis develop. When the inflammatory phenomena subside, the erosions heal and new blisters no longer appear, we can say that the pathology has become squamous in nature.

The course of the disease is torpid, long-term, exacerbations occur in summer and spring. The localization of the lesion is usually one-sided. In addition to the above symptoms, dyshidrotic athlete's foot causes a temperature reaction, general malaise, and headache. Epidermophytids occur - common allergic rashes. The acute phase lasts on average one to two months; during this period, the disease responds well to treatment, but relapses also occur.

Erased form

This variant of the disease has subtle symptoms. It manifests itself as small areas of peeling or cracks in the spaces between the fingers.

Athlete's nails

The pathology begins with changes in the free edge of the nail in the form of yellow stripes and spots. Then the entire nail plate thickens and turns yellow. It breaks and crumbles easily, and subungual hyperkeratosis occurs (horny masses accumulate). Sometimes the opposite situation occurs: the nail becomes thinner and is torn away from the nail bed - this process is called onycholysis. The nail plates on the first and fifth toes are often affected. The pathological process does not affect the fingers.

Diagnostics

The diagnosis is made based on the physician recording characteristic clinical manifestations and detecting filaments of fungal mycelium during microscopic examination. Material for analysis in intertriginous and dyshidrotic forms of the disease should be taken along the periphery of the lesions from the exfoliating macerated epidermis. In the case of the squamous form, scales are scraped off from the lesions. As for the nail plates, the horny masses are scraped off with a scalpel or the free edge of the nail is cut off with scissors. The resulting material is soaked in a solution of caustic alkali and examined under a microscope with high magnification.

Athlete's foot: treatment

Treatment can be done at home through over-the-counter medications and foot care. However, if the pathology has developed against the background of diabetes, there is a large area of ​​damage, or a secondary infection has occurred, you should consult a specialist.

Antifungal drugs such as Lamisil, Lotrimin, Mikatin, Tinactin are used. They are available in different forms: solutions, creams, gels, lotions, sprays, powders, ointments. These are local preparations, that is, those that are applied directly to the skin. Therapy is carried out over one to six weeks.

If a vesicular infection (blisters) occurs, you should soak your feet several times a day with the solution for at least three days until the liquid disappears from the blisters. After this, you need to apply an antifungal cream.

To prevent athlete's foot from recurring, treatment should be carried out efficiently and all prescribed medications should be used until the symptoms are eliminated. You should avoid using hydrocortisone cream if you have a yeast infection unless your doctor advises otherwise.

Foot care

Feet should be kept dry and clean by:

• dry the skin between your fingers after bathing or swimming;
• wear socks at home;
• walk in shoes that allow your feet to breathe;
• Wear moisture-wicking cotton socks and change them twice a day;
• apply antifungal powder or talc to the feet;
• wear flip-flops in public swimming pools, bathhouses and similar places.

If you have athlete's foot, after taking a bath or shower, you should first dry the groin area, and only then your legs. You should also put on socks first, and then underwear. Such actions will prevent further spread of the fungal infection from the feet to the groin area, which can lead to inguinal athlete's foot.

Some people do not treat the pathology in question because they do not have severe symptoms. However, it should be remembered that untreated athlete's foot can lead to the appearance of cracks and blisters, and this is fraught with the addition of a severe bacterial infection. In addition, if you do not treat the disease, you can infect other people with it.