Athlete's foot

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Athlete's foot
Classification & external resources

ICD-10	B35.3
ICD-9	110.4
DiseasesDB	13122
MedlinePlus	000875
eMedicine	derm/470

Athlete's foot or tinea pedis is a fungal infection of the skin of the foot, usually between the toes, caused by the pathogen fungi.

Contents 1 Causes 2 Symptoms 3 Treatments 3.1 Conventional treatments 3.2 Alternative treatments 3.2.1 Topical oils 3.2.2 Vinegar 3.2.3 Urine therapy 4 Footnotes 5 External links

[edit] Causes

The body normally hosts a variety of saprotrophic microorganisms, including bacteria and fungi. Some of these are useful to the body. Pathogenic or disease causing organisms or the overgrowth of saprotrophic ones can multiply rapidly and cause infection. Athlete's foot is a layman's description of a skin fungal infection. Fungal infections of the skin are called dermatophytosis. Dermatophytes may be spread from other humans (anthropophilic), animals (zoophilic) or may come from the soil (geophilic). Anthropophillic dermatophytes are restricted to human hosts and produce a mild, chronic inflammation. Zoophilic organisms are found primarily in animals and cause marked inflammatory reactions in humans who have contact with infected cats, dogs, cattle, horses, birds, or other animals. Geophilic species are usually recovered from the soil but occasionally infect humans and animals. They cause a marked inflammatory reaction, which limits the spread of the infection and may lead to a spontaneous cure but may also leave scars. Infections or infestations occur when dermatophytes grow and multiply in the skin.

[edit] Symptoms

Athlete's foot causes scaling, flaking and itching of the affected skin. Blisters and cracked skin may also occur, leading to exposed raw tissue, pain, swelling and inflammation. The infection can be spread to other areas of the body, such as the armpits, knees, elbows, and the groin, and usually is called by a different name once it spreads (such as tinea cruris or jock itch for an infection of the skin and groin cool

[edit] Treatments

Since the fungus thrives in a moist warm environment keeping the feet dry and cool can cure the infection. It is recommended to wear open sandals, or even better barefoot as much as possible. [1]

However avoid walking barefoot in warm moist environments since you may infect other people, and allowing your feet to stay wet can help the fungus grow.

Keep the feet clean- but make sure they are fully dry after washing them. This may require showering in the evening instead of the morning, and staying barefoot afterwards.

Change socks daily, and try to alternate shoes on different days, to allow the shoes to fully dry out.

Placebo controlled studies report that good foot hygiene alone can cure athlete's foot even without medication in 30-40% of the cases. [2]

[edit] Conventional treatments

The infection is often treated with topical antifungal agents such as miconazole, itraconazole, terbinafine and a keratolytic such as salicylic acid. Topical agents only clear the infection about 30% of the time and provide mycologic cures (absence of organisms) less than 15% of the time. The time line for cure may be long, often 45 days or longer. However, because the itching associated with the infection subsides quickly, patients may not complete the courses of therapy prescribed. Washing socks, underwear and bed clothes at 60C or 140F will also help prevent any reinfection.

Some topical applications such as Castellani's Paint, often used for intertrigo, work well but in small selected areas. Carbol Fuscin Red dye used in this treatment like many other vital stains is both fungicidal and bacteriocidal; however, because of the staining are cosmetically undesirable. For many years gentian violet was also used for interdigital and other bacterial and fungal infections.

Oral treatment with griseofulvin was begun early in the 1950s. Because of the tendency to cause liver problems and to provoke aplastic anemia the drugs were used cautiously and sparingly. Over time it was found that those problems were due to the size of the crystal in the manufacturing process and microsize and now ultramicrosize crystals are available with few of the original side effects. Oral treatment provides long lasting mycologic cure.

If the fungal invader is not a dermatophyte but a yeast, other medications such as fluconazole may be used. Typically diflucan is used for candidal vaginal infections moniliasis but has been shown to be of benefit for those with cutaneous yeast infections as well. The most common of these infections occur in the web spaces (intertriginous) and at the base of the fingernail or toenail. The hall mark of these infections is a cherry red color surrounding the lesion and a yellow thick pus.

Undecylenic acid (Castor oil derivative) is an effective fungicide for fungal skin infections such as athlete's foot.

[edit] Alternative treatments

[edit] Topical oils

Users report instant relief from itching after topical application of tea tree oil or crocodile oil, allowing lesions to heal due to the cessation of scratching the itch.^{[citation needed]}(ref)

[edit] Vinegar

Soaking the affected foot completley in a small bucket filled with vinegar (for about an hour) will allow the vinegar to soak into the flesh of the foot and under the toe nails. The vinegar kills off the bacteria or fungus which causes the athelet's foot from its source. Depending on the severity of the foot's condition this treatment can be 2 or 3 times, however you should allow 1 or 2 days between treatments to allow the foot to recuperate .

[edit] Urine therapy

Proponents of urine therapy claim that urine is very effective at killing athlete's foot. Urea, the "active ingredient" in urine, is already used in many drugs and treatments made by pharmaceutical companies to treat athlete's foot. This controversial treatment method recommends urinating on the infected area once a day in the shower. According to supporters, urine therapy not only kills existing fungi, it prevents new fungi from growing in the infected area.^{[citation needed]}

One biochemist states that urea is only used to soften the outer layers of skin so that antifungal drugs can reach fungi below the surface, and that the urea must be concentrated and applied for a long period of time in order to be effective.^[1] According to another article about high-concentration urea cream, the compound is used to "dissolve proteins and [as a] denaturant. The ability of urea to macerate [tissue] has been attributed to a 'proteolytic effect', but others attribute the maceration to the hydrating properties of urea."^[2] This use requires a high concentration of urea, up to 40%, and extended exposure. Urea itself without the presence of an additional antifungal drug is not referred to in scholarly literature as having antifungal properties. Thus, it is unlikely that urinating on one's feet in the shower will significantly improve a case of athlete's foot.^[3]

This theory was recently covered on The Straight Dope for March 30^th, 2007 [3]

[edit] Footnotes

1. ^ Onken M (29 March 2003). Re: Peeing in the shower reduces foot fungus. True or false. Why?. MadSci Network. Retrieved on October 22, 2006.
2. ^ Shah M (2003). "Urea ointment (40%)". Indian Journal of Dermatology, Venereology and Leprologu 69 (6): 421-2. 
3. ^ Burgess J (15 July 2006). "Water cure". New Scientist 2560: 89. 

[edit] External links

• Page about Urine Therapy (UT)
• eMedicine Health Athlete's Foot
• eMedicine and Mycetoma
• Society of Chiropodists and Podiatrists[[pt:Pé de atleta]