Tinea Pedis

Dermatophytes are fungi that infect skin, hair, and nails and include members of the genera Trichophyton, Microsporum, and Epidermophyton.

Infection of the foot (tinea pedis) is most common and is often chronic; it is characterized by variable erythema and edema, scaling, pruritus, and occasionally vesiculation. Involvement may be widespread or localized, but almost invariably the web space between the fourth and fifth toes is affected.

Treatment of Tinea Pedis

Both topical and systemic therapies may be used to treat dermatophyte infection. Treatment depends on the site involved and the type of infection. Topical therapy is generally effective for uncomplicated tinea corporis, tinea cruris, and limited tinea pedis. It is not effective as monotherapy for tinea capitis or tinea unguium.

Topical imidazoles (miconazole, ketoconazole, econazole, clotrimazole, oxiconazole, and sulconazole), triazoles (terconazole), and allylamines (terbinafine and naftifine) may all be effective topical therapies for dermatophyte infections.

Haloprogin, undecylic acid, ciclopirox-olamine, and tolnaftate are also effective, but nystatin is not active against dermatophytes. Treatment should continue until the patient is clear of infection by clinical examination and culture. Tinea pedis often requires longer treatment courses and is associated with a high relapse rate.