Dermoscopy as a diagnostic tool to differentiate between tinea pedis and plantar psoriasis

<p><strong>Background</strong>: Clinical differentiation between tinea pedis and plantar psoriasis may sometimes be challenging, with consequent diagnostic delays and unnecessary therapies; in such cases histopathological analysis helps to differentiate the 2 conditions. In this study we used a dermoscope as a non-invasive tool to investigate the significance of specific dermoscopic features and to improve their non-invasive differentiation.</p><p><strong>Methods:</strong> A clinical diagnosis of plantar psoriasis/tinea pedis was made on basis of accepted literature and proved by histopathology. Image capturing was performed using a dermoscope. Based on combination of history, clinical, and dermoscopic examination conclusive diagnosis with specific dermoscopic features for each disease was achieved.</p><p><strong>Results:</strong> The 15 patients of biopsy proven tinea pedis and 17 patients of biopsy proven plantar psoriasis were selected. We found that the presence of whitish powdery scales located in the furrows with apparently uninvolved skin in between was significant in tinea pedis whereas the presence of silvery white scales on a pinkish red erythematous background with regularly distributed red dots was significant in plantar psoriasis.</p><p><strong>Conclusions:</strong> Dermoscopy showed significant patterns in tinea pedis and plantar psoriasis due to their well-known different histological and physio pathological background, with white diffuse scales reflecting the dry and hyperkeratotic nature of plantar psoriasis and the red dots signifying the pin point blood vessels seen clinically as Auspitz sign. The peculiar scaling in tinea pedis might result from the predilection of dermatophytes to proliferate in moist environment, such as the furrows.</p>

Epidemiology, evaluation and management of tinea pedis

Tinea pedis, known as athletics foot, is defined as a dermatophyte infection leading to a condition called dermatophytosis. Usually, the mode of infection is fungal. Trichophyton rubrum is the most common organism which is responsible for the infection. This fungus is endemic in some geographical regions as in Asia and Africa. The mode of transmission and risk factors depends on several factors: the weather, type of clothes and shoes, body response to different organisms, present history, family history, and endemic geographical areas. Increased temperature and humidity were correlated in the literature to the increased incidence and prevalence of tinea pedis compared to those areas which have low temperature, wearing specific types of shoes or clothes might be associated with an increased rate of infection, especially if the shoes are adherent to the foot and occlusive, prolonged exposure to humidity and water was also shown to be among the causes for tinea pedis infections. The clinical presentation of tinea pods varies according to the site and severity of infection. Generally, antifungal drugs are effective in most cases. The application of antifungals may be in oral form or local form, or mixed form. Terbinafine was proven to be effective in mild cases to fully treat the infection within a period of one week, extending to four weeks in more aggressive cases. This was a brief look at the article. This article aimed to review tinea pedis from different prospections clinically.

Isolation and Identification of Dermatophytes from Collegiate Runners

Competitive runners experience various risk factors that render them more susceptible to superficial cutaneous fungal infections, including the use of occlusive footwear, shared locker rooms, submission of feet to constant maceration, trauma, sweating, and having depressed immune function. The goal of this work was to assess the prevalence of athlete’s foot fungi in cross country runners at St. John Fisher College. Toe webs of 16 collegiate runners were sampled and volunteers surveyed about their shoe habits, foot hygiene, and average miles run per week. Lack of tinea pedis-causing fungi in asymptomatic cross- country runners shifted the study to investigate the identities of fungi morphologically similar to athlete’s foot and look for correlations with volunteers’ running habits and hygiene. Thirty-five distinct fungal cultures were isolated and compared to a known Trichophyton rubrum strain both microscopically and macroscopically. Four samples were preliminarily identified as tinea pedis-causing fungi and sequenced to confirm molecular identification. Fungal DNA was isolated, purified, and PCR amplified using primers for the internal transcribed spacer region, D1/D2 region of the 28S subunit, and β-Tubulin gene. Three of the four isolates were identified as Fusarium equiseti, a soil-borne plant pathogen with rare human pathogenicity reported. The fourth isolate was Beauveria bassiana, a common soil-borne pathogen that can infect immunocompromised individuals. Correct dermatophytic identification and understanding of the interplay between species is important to provide correct treatment, prevent spread among athletes and within facilities, and determine how opportunistic pathogens might play a role in people with immune suppressed function, which includes runners.

Condiciones de trabajo y salud en población recicladora de un asentamiento precario de Asunción (Paraguay). Un estudio desde el análisis de prevalencias dermatológicas

Objetivo: Este artículo tiene como objetivo realizar un análisis comparativo de la prevalencia de enfermedades dermatológicas, antecedentes en salud y medidas de protección de seguridad y salud en el trabajo entre la población recicladora y no recicladora que vive alrededor del vertedero municipal de la ciudad de Asunción, en Paraguay. Metodología: Estudio descriptivo y transversal, con una muestra no aleatoria intencional en cuatro microterritorios, que incluyó 40 personas de entre 15 y 76 años: 22 recicladores y 18 no recicladores. Resultados: Se encontró que los recicladores presentaron mayor prevalencia de enfermedades dermatológicas en el examen físico y en antecedentes de salud, entre los cuales se identificó un 63,7 % con tres o más lesiones en piel (en contraste con un 16,6 % de los no recicladores), y pronunciados porcentajes en enfermedades infecciosas cutáneas: micosis (50 %) y de origen bacteriano (31,8 %). En antecedentes cutáneos, los recicladores resultaron con mayores proporciones en heridas por corte (59,1 %), forúnculos (59,1%), tunga penetrans (40,9 %), larva migrans cutánea (36,4 %), heridas infectadas por corte (27,3 %), fotodaño (22,7 %), tinea pedis (13,6 %) y heridas por punción de jeringa (9,1 %). Estos reportaron también mayores porcentajes respecto a frecuentes problemas respiratorios, gastrointestinales, cefaleas y dolores musculoesqueléticos. Se constataron insuficientes medidas de protección de seguridad y salud en los trabajadores dedicados a la actividad del reciclado. Conclusión: Estos resultados sugieren un mayor potencial de exposición del grupo de recicladores a una variedad de fuentes de riesgos en salud relacionadas con las condiciones precarias de su actividad laboral, lo cual apunta a un desafío prioritario para la salud pública.

Afecções dermatológicas em pés de militares: revisão narrativa da literatura

Este estudo teve como objetivo construir uma revisão bibliográfica Narrativa, versando sobre histórico, etiologia, diagnóstico, prevenção e tratamento das afecções dermatológicas mais comuns em pés de militares a partir da análise de artigos científicos sobre o tema. Foi realizada uma pesquisa nos bancos de dados PubMed, Lilacs e SciELO, em língua inglesa e portuguesa, com os descritores “trench foot”, “military”, “dermatophytosis” e “Tinea pedis”, publicados no período entre 2002 e 2021. O pé de trincheira e as infecções fúngicas e bacterianas são as principais afecções que acometem os pés de militares. O uso constante de botas, a facilidade de contágio no ambiente militar e principalmente o ambiente interno do calçado são considerados fatores de risco. A prevenção e o tratamento destas afecções são ainda desafiadores. A desinfecção do calçado por gás ozônio mostra-se como estratégia preventiva destas condições. Enfatiza-se a complementação do tratamento preventivo com a desinfecção das botas militares como formas de se evitar baixas em missões por estas afecções podais, especialmente as infecciosas. Apesar de responder por expressivas baixas em cenários militares, as afecções nos pés continuam prevalentes neste segmento social. Estratégias preventivas devem ser mais sedimentadas nesta população. A introdução de tecnologias de desinfecção de botas parece ser promissora na redução da incidência das infecções podais.

ROSEOFUNGIN-AS, OINTMENT 2% FOR TREATMENT OF TINEA PEDIS AND TINEA CORPORIS: RESULTS OF A RANDOMIZED, BLINDED, PROSPECTIVE, MULTICENTER PHASE III CLINICAL TRIAL

Розеофунгин-АС, мазь 2% для наружного применения разработана для лечения микозов кожи разной этиологии, вызванных дерматофитными, дрожжеподобными и плесневыми грибами. Многоцентровое слепое проспективное рандомизированное исследование проводили в Республике Казахстан для сравнения терапевтической эффективности и безопасности препаратов «Розеофунгин-АС, мазь 2%» и «Клотримазол, крем 1%» при лечении tinea pedis и tinea corporis. Препараты применяли 2 раза в день в течение 28 дней. Лабораторные общеклинические и биохимические обследования пациентов проводили на 0, 14 и 28 дни исследования. Микологическое обследование включало микроскопические и культуральные исследования, которые проводились до лечения и на 28-30-й день после окончания лечения. В клиническое исследование III фазы входили 410 пациентов, включая 290 пациентов с tinea pedis и 120 пациентов с tinea corporis. Лечение препаратом «Розеофунгин-АС, мазь 2%» получали 310 пациентов, лечение препаратом «Клотримазол, крем 1%» - 100 пациентов. У больных обеих групп уже на 14 день уменьшалась выраженность субъективных и объективных проявлений. К 28 дню практически все клинические признаки патологического процесса отсутствовали. Совокупная клинико-микологическая эффективность препарата «Розеофунгин-АС, мазь 2%» составила 99,1%, препарата «Клотримазол, крем 1%» - 98,0%. Препарат «Розеофунгин-АС, мазь 2%» проявил высокую эффективность при лечении грибковых инфекций tinea pedis и tinea corporis, вызванных возбудителями трихофитии (Trihophyton rubrum, T. violarum, T. tonsurans), микроспории (Microsporum canis, M. gypseum), кандидоза (Candida albicans, Candida spp.), плесневыми грибами (Penicillium glaucum). В исследовании не были зафиксированы аллергические реакции и индивидуальная непереносимость исследуемого и референтного препаратов. Препарат «Розеофунгин-АС, мазь 2%» является эффективным антимикотическим средством, клинико-микологическая эффективность которого в терапии микозов кожи составляет 99,1%. Препарат имеет высокий уровень переносимости, безопасности и приемлемости RoseofunginAS, ointment 2% for external use was developed for the treatment of skin mycoses of various etiologies caused by dermatophytic and yeastlike fungi and molds. A multicenter, blind, prospective, randomized trial was conducted in the Republic of Kazakhstan to compare the therapeutic effectiveness and safety of RoseofunginAS, ointment 2% and Clotrimazole, cream 1% in the treatment of tinea pedis and tinea corporis. The drugs were administered twice daily for 28 days. Laboratory general clinical and biochemical examinations of patients were performed on days 0, 14, and 28 of the trial. Mycological examination included microscopic and cultural studies, which were carried out before treatment and on days 2830 after the end of treatment. The Phase III clinical trial involved 410 patients, including 290 with tinea pedis and 120 with tinea corporis. Treatment with RoseofunginAS, ointment 2% was administered to 310 patients, 100 patients were treated with Clotrimazole, cream 1%. In patients of both groups, the severity of subjective and objective manifestations decreased already on day 14. By day 28, almost all clinical signs of the pathological process were absent. The cumulative clinical and mycological effectiveness of the drug RoseofunginAS, ointment 2% was 99.1% and that of the drug Clotrimazole, cream 1% reached 98.0%. The drug RoseofunginAS, ointment 2% exhibited high effectiveness in the treatment of fungal infections, including tinea pedis and tinea corporis, with pathogens that cause trichophytosis (Trihophyton rubrum, T. violarum, T. tonsurans), microsporia (Microsporum canis, M. gypseum), candidiasis (Candida albicans, Candida spp.), and molds (Penicillium glaucum). The study did not record allergic reactions and individual intolerance to the study and reference drug. The drug RoseofunginAS, ointment 2% is an effective antimycotic agent, the clinical and mycological effectiveness of which in the treatment of skin mycoses was 99.1%. The drug possesses a high level of tolerance, safety and acceptability.

Dermatophytic Diseases: A Review of Tinea Pedis

Background Skin diseases, particularly Tinea pedis are very rare in Ghana leading to low investment in dermatological services in the country and the African continent. Globally, Tinea pedis affects about 15% of the global population. Importantly, it is a major public health problem and socioeconomic issue. Currently, the most recommended treatment for Tinea pedis infection are polyenes, azoles, allylamines, and fluorocytosines. Although these drugs are effective, they do have adverse side effects and are limited in the clinical settings in developing countries especially Ghana. Method: Research papers were collected from Pubmed, Google scholar, chemical abstracts, and journal websites, reporting both in vitro and in vivo information on Tinea pedis. General information on Tinea pedis, the methods of infection, transfer, treatment options, and resistance were obtained after screening the articles. Many agents are involved in cases of Tinea pedis but are predominantly caused by Trichophyton rubrum which feeds on the keratinous layer of the topmost skin of the foot causing skin discoloration, itching, and maceration. The disease is influenced by individual lifestyle, environmental conditions, and individual factors such as age, sex, and host immunity and is prevented by the maintenance of good personal hygiene.Tinea pedis like other tinea infections are treated with both topical and systemic agents. The classes of medications used in the treatment of Tinea pedis are polyenes, azoles, allylamines, and fluorocytosines. Tinea pedis antifungal resistance development could be partly associated with incomplete medication and misuse of antifungal medications. Additionally, patients with serious underlying health conditions such as compromised immune systems like HIV/AIDS, diabetes, radiotherapy for cancer, and transplantation could complicate resistance. Conclusion: Although, fungal diseases do not cause epidemics the increasing rate of fungal infections and therefore Tinea pedis has to be checked and prevented. High budgets are made in the development of medications which mostly lose their effectiveness over time due to resistance development. Good personal hygiene is very effective but the available medications must be used appropriately for effective treatment and resistance avoidance. Infection prevention and control, tracking and data sharing, good and easily accessible antifungals, vaccines, and maintenance of personal and environmental hygiene are the topmost preventive measures against resistance development.