Gearing up for Triathlon Season?

Whether you're brick training for a triathlon, showering at the gym after your sweat session or taking the kids to the pool, never go barefoot! With our feet finally getting some fresh air after being bundled up during the winter, people hesitate to take precautions, because it's just so nice for the little piggies to be free!!

However, it's in your best interest if you want your feet to be fungus free for the rest of the summer! So step up (pun intended) and keep flip flops on those feet in these wet & warm environments!

Here are a few symptoms of Athlete's Foot:

• Dry skin
• Itching and burning, which may increase as the infection spreads
• Scaling
• Inflammation
• Blisters, which often lead to cracking of the skin

Take your precautions:

• Wash feet daily with soap and water; dry carefully, especially between the toes
• Avoid walking barefoot; use shower shoes
• Reduce perspiration by using talcum powder
• Wear light and airy shoes
• Change shoes and hose regularly to decrease moisture
• Wear socks that keep your feet dry, and change them frequently if you perspire heavily

When to make an appointment:

If you are taking the preventitive measures suggested and aren't seeing the fungus clearing up, call Shenandoah Podiatry in Blacksburg (540) 808-4343 or Troutville (540) 904-1458 to find out your treatment options!

source: apma.org

Erythrasma

Erythrasma is a chronic superficial infection of the intertriginous areas of the skin. This is a bacterial infection and can be found between the toes. It commonly occurs between the 3rd and 4th toes.


History/Physical:

This infection usually occurs in areas of body folds that are moist. The infection can be asymptomatic or itching may be associated with the infection.

The infection consists of a well-defined area with brown-red patches commonly found. Scaling may be present, as well as fissuring and maceration. The affected area may resemble athlete's foot.


Causes:
Corynebacterium minutissimum - A bacterium found on the skin


Predisposing factors:

Excessive sweating

Obesity

Diabetes mellitus

Warm climate

Poor hygiene



Differential Diagnosis:

Candidiasis

Contact dermatitis

Psoriasis

Tinea pedis (athlete's foot)



Workup:

Wood light examination - Reveals coral red fluorescence

Gram stain - Reveals gram-positive filamentous rods



Treatment:

Antibiotics - Erythromycin is the drug of choice. Your doctor may prescribe 1-2 weeks of antibiotic therapy.

Your doctor may also prescribe a topical antibiotic to treat this infection.

Tinea Pedis

Is a fungal infection of the skin that causes scaling, flaking, and itch of affected areas. It is also known as Ring Worm or Athlete's foot.

Symptoms
The symptoms of athlete's foot or tinea pedis typically include itching and burning of the feet.

The skin may peel or crack with or without any associated pain.

Commonly the rash is localized to the soles of the feet.

Sometimes the flaking skin may spread to the sides and tops of the feet in a moccasin distribution.


The digital interspases may have some moisture, peeling, redness and flaking as well.



Types of Tinea Pedis


T rubrum is the most common cause for tinea pedis.

Trichophyton mentagrophytes, and Epidermophyton floccosum are other causative organisms.




Vesicular tinea pedis-
Usually caused by T mentagrophytes.
This type is characterized by painful, pruritic vesicles most often on the instep.






Interdigital tinea pedis-Usually caused by T rubrum seen more in hot/ humid environments
This type is characterized by redness, maceration, fissuring, and scaling between toes. It is also associated with itching




Chronic hyperkeratotic tinea pedis-usually caused by T rubrum.
This type is characterized by chronic redness on the bottom of the foot or sides with scaling.




Risk Factors

• A hot, humid, tropical environment
• Prolonged use of footwear
• Hyperhydrosis- Sweating
• Certain people may have a genetic predisposition to the infection

Work Up

In suspected tinea pedis a KOH (potassium hydroxide) staining may be ordered by the doctor for fungal detection by obtaining a sample of the flaking skin

Fungal culture- may be performed to confirm the diagnosis of tinea pedis. A culture can be used to identify the fungal species.



Treatment

Tinea pedis can be treated with topical or oral antifungals. Some topical medications are over the counter. Topical agents are generally used for 1-6 weeks


Examples of Topical Medication

Topical Imidazoles

• Clotrimazole 1% (Lotrimin)
• Econazole 1% cream (Spectazole)
• Ketoconazole 1% cream (Nizoral)

Topical Pyridones

• Ciclopirox 1% cream (Loprox)

Topical Allylamines

• Naftifine 1% cream (Naftin)
• Terbinafine (Lamisil)

Oral Antifungals

Considered in patients with extensive chronic hyperkeratotic or inflammatory/vesicular tinea pedis

• Terbinafine (Lamisil)
• Itraconazole (Sporanox)

Prevention

• Keeping your feet clean and dry
• Avoiding prolonged moist environments
• Disinfecting old shoes
• Periodic use of anti fungal foot powder in the shoes

                                                         Learn more at http://www.shenandoahpodiatry.com/