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 turns red and swells.
Definition of disease
Mycosis of the feet, or dermatophytosis, is an infectious disease caused by dermatophyte molds. In total, 43 species of dermatophytes are known, 30 of them lead to mycosis of the feet. Most often these are the fungi Trichophyton rubrum (90%), Trichophyton mentagrophytes, and less commonly Epidermophyton. Mycosis of the feet is caused much less frequently 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 forms the upper part of the skin of humans and animals. The skin is damaged.
Once on the skin, the fungi are directed to the most vulnerable places - the junctions between the cells of the epidermis. There they penetrate inside and begin to actively grow. However, fungi rarely penetrate deeper than the granular layer of the skin. Usually they are limited only to the upper, keratinized tissues.
Prevalence of mycosis of 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 of the skin occur most often - in approximately 30% of cases.
According to dermatologists, up to 20% of the adult population suffers from mycosis of the feet. Pathology is found twice as often in men.
Among people over 70 years of age, foot fungus is found in almost every second patient - this is explained by the fact that older people 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 provoked by fungi of the genus Candida (Candida) and mold (Scytalidium dimidiatum, Scytalidium hyalinum).
According to some studies, the proportion of dermatophytes in the structure of causative agents of mycosis of the feet is gradually decreasing. Candida mushrooms come to the fore.
Risk factors for developing mycosis of the feet:
- violation of personal hygiene;
- sharing shoes (for example, in bowling alleys, skate and ski rental shops);
- visiting public baths, swimming pools, beaches;
- climatic features: the risk of getting sick is higher in countries with subtropical and tropical climates - this is due to increased humidity and ambient temperature;
- constantly wearing closed, tight shoes (this happens among military personnel, miners, workers in the textile and metallurgical industries);
- frequent injuries to the toes due to flat feet, calluses, corns;
- non-compliance with sanitary rules during pedicure;
- impaired blood supply to the legs;
- immunodeficiency conditions, including HIV;
- chronic dermatoses;
- obesity;
- diabetes;
- chronic venous insufficiency;
- taking certain medications (systemic glucocorticosteroids).
Symptoms of mycosis of the feet
Symptoms of mycosis of the feet, as well as features of 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 of the feet is the dermatophyte Trichophyton rubrum.
At 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 in color. Then, as the disease spreads to the lateral and dorsal surfaces of the feet, a characteristic inflammatory ridge 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.
Often, simultaneous infection of the skin of the feet with dermatophyte fungi (usually Trichophyton mentagrophytes var. interdigitale) and the bacterium Staphylococcus aureus occurs.
Dyshidrotic form of mycosis of the feet
As a rule, the causative agent of this form of mycosis of the feet is Epidermophyton floccosum (flaky epidermophyton).
The dyshidrotic form of mycosis of the feet, as a rule, is more severe and is accompanied by painful itching and pain. Blisters with a thick covering form on the skin. Merging, they form large multi-chambered blisters, which, after opening, turn into moist pink-red erosions and then into brown crusts.
The disease is difficult to treat and often recurs.
A characteristic feature of the dyshidrotic form is damage to the arch of the foot, interdigital folds and skin of 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 become 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 mycosis of the feet
Most often, the exudative-dyshidrotic form of mycosis of the feet is caused by the fungus Trichophyton rubrum (red trichophyton).
The skin between the fingers is affected first. Then the process spreads to the sole, dorsal and lateral surfaces of the foot, and nail plates. Blisters and erosions appear on the skin, which then become covered with crusts. The skin becomes wet and may fester.
Erased form of mycosis of the feet
The erased form is identified by some researchers. It is believed that it occurs a few days after infection with the fungus.
The skin in the interdigital folds begins to peel off. There may also be slight peeling on the soles and sides of the feet. Patients may ignore unpleasant symptoms, but they still infect others.
Acute form of mycosis of 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 the legs. The skin swells. Then nodules form on the hands and lower third of the forearms.
After the blisters open, erosions appear, surrounded by scraps of loose skin. They merge, turning into extensive weeping surfaces, often with purulent discharge.
The disease is often accompanied by fever, deterioration of the patient's general condition, and sharp pain in the affected hands and feet. The inguinal and femoral lymph nodes enlarge and become painful.
Vesiculobullous (inflammatory) form of mycosis of the feet
The inflammatory form of mycosis of the feet is usually identified by foreign authors, often defining it as acute. It can develop from a chronic interdigital form of dermatophytosis.
As a rule, the causative agent of the vesiculobullous form is the dermatophyte Trichophyton rubrum.
Main symptoms: severe itching, skin rashes, localized mainly on the soles, at the base and on the sides of the fingers, on the back of the foot. Swelling areas with blisters on the surface may appear. The bubbles can merge or remain unchanged for a long time - if the tire (upper 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 ulcers on the skin that appear at the site of mycosis are the entrance gates 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 resistance of bacteria to drugs.
The most common complications of mycosis of the feet:
- allergic dermatitis of infectious and drug origin;
- pyoderma - pustular skin diseases (cellulitis, lymphangitis, phlegmon, osteomyelitis of the bones of the foot), which can lead to deep, long-lasting skin wounds;
- plantar warts;
- microbial eczema is a chronic inflammatory disease in which the skin itches and turns red, and blisters with liquid form on it;
- a general decrease in immunity and impaired 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 in 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 of the feet.
At the appointment, the doctor will assess the condition of the patient’s nails, skin, mucous membranes and hair. He will conduct 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.
Examination of skin scrapings will rule out or confirm a fungal infection.
The doctor may also refer the patient for microscopic examination and culture.
Sowing, or the cultural method, allows you to obtain more accurate information about the causative agent of the disease, although it takes longer - usually a month.
Diabetes mellitus can significantly worsen the course of mycosis of the feet and lead to serious complications. Complex studies can exclude 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 in the diagnosis of anemia, diseases of the hematopoietic organs, allergic reactions and autoimmune diseases.
Also, before recommending antifungal therapy, the doctor may prescribe the patient a biochemical blood test - this study will determine the level of bilirubin and liver enzymes ALT and AST. Such information will help the doctor choose the dosage of the drug and minimize the risk of side effects.
Treatment of mycosis of the feet
Treatment of mycosis of the feet is carried out in two stages.
At the first stageIf 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). Then pastes and ointments are prescribed that contain antifungal and glucocorticosteroid drugs.
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 antimycotic - antifungal - agents.
At the main stagetreatment uses antifungal drugs designed to destroy pathogenic fungi. Most often, such medications are produced in the form of ointments, creams or solutions.
If the patient is bothered by severe itching, the dermatologist may prescribe antihistamines. They are usually taken for 10-15 days, until the unpleasant symptom completely disappears.
When 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, eliminating the risk of side effects.
If external medications do not produce an effect, systemic antimycotic agents are prescribed.
The treatment regimen and dosage of drugs is 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 a timely manner, the prognosis for mycosis of the feet is favorable: most patients treated with antifungal drugs get rid of the disease forever.
To prevent mycosis, you need to 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 wearing;
- use an antifungal UV shoe dryer;
- do not wear shared slippers when visiting;
- do not try on shoes in a store on 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 foot fungus?
To treat fungus on the legs, antimycotic 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 mycosis of the feet, an infectious disease caused by dermatophyte molds.