Tinea pedis

A. Tinea pedis ("athlete's foot") is the most common dermatophyte infection. Tinea pedis infection is usually related to sweating, warmth, and oclusive footwear. The infection often presents as white, macerated areas in the third or fourth toe webs or as chronic dry, scaly hyperkeratosis of the soles and heels.

B. Occasionally, tinea pedis may produce acute, highly inflamed, sterile vesicles at distant sites (arms, chest, sides of fingers). Referred to as the "dermatophytid" or "id" reaction, these vesicles probably represent an immunologic response to the fungus; they subside when the primary infection is controlled. The "id" reaction can be the only manifestation of an asymptomatic web space infection.

C. Tinea pedis is often treated with topical therapy. Oral itraconazole and terbinafine are more efficacious in the treatment of hyperkeratotic tinea pedis. Once-weekly dosing with fluconazole is another option, especially in noncompliant patients.

VII. Tinea manuum is a fungal infection of the hands. Tinea manuum presents with erythema and mild scaling on the dorsal aspect of the hands or as a chronic, dry, scaly hyperkeratosis of the palms. When the palms are infected, the feet are also commonly infected. Treatment options are the same as for tinea pedis.

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