Fungal Infections

Disease name and synonyms

Athlete’s foot, tinea pedis (dermatophytosis of the foot)

Fungi responsible (links to these)

Trichophyton rubrum, T. interdigitale, , rarely other species

Disease description

The most common infection is between the toes, especially between the 4th and 5th toes and 3rd and 4th toes. Cracking with a painful fissure is the commonest symptom.

Infection of the whole of the foot with a scaling eczema reaction and fissuring of the heel is also common (moccasin type). Occasionally an inflammatory reaction of the feet is seen.

Frequency and global burden

Fungal infection of the skin, hair or nails affects ~25% of the world’s population (~1.5 billion)

Underlying problems and at risk patients

Athlete’s foot affects anyone at any age, but is more common in those who have dampness between their toes relates to sports, swimming, frequent bathing or hot climates without drying between the toe webs.

Diagnostic testing

Microscopy and fungal culture


Terbinafine 1% cream or clotrimazole 1% cream for athlete’s foot,

Oral itraconazole or terbinafine for moccasin type infection for 3 weeks

Outlook and prognosis

Responds well to therapy but tends to recur.

Lower leg cellulitis complicates athlete’s foot.



Athlete’s foot between the toes

Moccasin type tinea pedis requiring oral antifungal therapy

Extensive flaking and fissuring, so typical of severe moccasin type T. rubrum tinea pedis.

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