Athlete's Foot Or Tinea Pedis

Athlete's foot is also known as tinea pedis. It is usually caused by fungi in the genus Trichophyton and affects the skin on the feet.
Athlete's foot is one of the most common fungal skin infections. 

Athlete's foot fungus may infect any part of the foot, but most often grows between the toes.

Causes And Risk Factors: Athlete's foot spreads easily. You can get it by touching the toes or feet of a person who has it. But most often, people get it by walking barefoot on contaminated surfaces near swimming pools or in locker rooms. The fungi then grow in the shoes, especially if the shoes are so tight that air cannot move around the feet.

Risk factors for getting infected with Athlete's foot are: 

• Male gender
• People who frequently wear damp socks or tight fitting shoes
• Sharing mats, rugs, bed linens, clothes or shoes with someone who has a fungal infection
• Walking barefoot in public areas where the infection can spread, such as locker rooms, swimming pools, communal baths and showers.

Clinical Features: Athlete's foot usually causes a scaly red rash. The rash typically begins in between the toes. Itching is often the worst right after the patient take off his/her shoes and socks.
Some types of athlete's foot feature blisters or ulcers.

There are different clinical types of Athlete foot and the presentations vary.

1. Toe Web Infection: usually occurs between the fourth and fifth toes. The skin becomes scaly, peels, and cracks. Some people also may have an infection with bacteria. This can make the skin break down even more.

2. Moccasin type infection: may start with a little soreness on the foot. Then the skin on the bottom or heel of the foot can become thick and crack. In bad cases, the toenails get infected and can thicken, crumble, and even fall out. Fungal infection in toenails needs separate treatment.

3.Vesicular type infection: usually begins with a sudden outbreak of fluid-filled blisters under the skin. The blisters are usually on the bottom of the foot. But they can appear anywhere on the foot. A superimposed bacterial infection can occur with this type of athlete's foot.

Complications: 

• As the disease progresses, the skin may crack, leading to bacterial skin infection and inflammation of the lymphatic vessels. 
• If allowed to grow for too long, athlete's foot fungus may spread to infect the toenails, feeding on the keratin in them, a condition called onychomycosis.
• Because athlete's foot may itch, it may also elicit the scratch reflex, causing the host to scratch the infected area before he or she realizes it. Scratching can further damage the skin and worsen the condition by allowing the fungus to more easily spread and thrive. The itching sensation associated with athlete's foot can be so severe that it may cause hosts to scratch vigorously enough to inflict excoriations (open wounds), which are susceptible to bacterial infection. Further scratching may remove scabs, inhibiting the healing process.
• Scratching infected areas may also spread the fungus to the fingers and under the fingernails. If not washed away soon enough, it can infect the fingers and fingernails, growing in the skin and in the nails (not just underneath). 
• After scratching, it can be spread to wherever the person touches, including other parts of the body and to one's environment. Scratching also causes infected skin scales to fall off into one's environment, leading to further possible spread.

Diagnosis: In most cases diagnosis is clinical by history and physical examination but is case of suspicion it can be confirmed by examining the skin scraping under the microscope and performing a KOH test for the fungus. 

Treatment: 

• In mild cases Athlete foot can be treated with over-the-counter antifungal ointment, lotion, powder or spray.
• Severe infections may require antifungal medications to be taken orally. 

Prevention: There are several preventive foot hygiene measures that can prevent athlete's foot and reduce recurrence. Some of these include:

• Keeping the feet dry, 
• Clipping toenails short; 
• Using a separate nail clipper for infected toenails;
• Using socks made from well-ventilated cotton or synthetic moisture wicking materials (to soak moisture away from the skin to help keep it dry); 
• Avoiding tight-fitting footwear, 
• Changing socks frequently; and 
• Wearing sandals while walking through communal areas such as gym showers and locker rooms