Mycosis of the feet (ICD code 10 B35. 3) is a fungal infection of the skin on the legs caused by parasitic dermatophytes. It occurs in about 20% of adults. Infection occurs through microtrauma, scratches, abrasions, wounds. The development of the disease is promoted by wet feet, diabetes mellitus, and weakened immunity.
Among people with endocrine disorders, immunodeficiency states, the prevalence reaches 50%. More often, the disease proceeds in a chronic form with alternating periods of remission and exacerbations. In 40-50% of cases, mycosis of the feet causes onychomycosis or a fungal infection of the nails.
Where and why does the infection occur?
Mycosis of the feet is a contagious disease that is easily transmitted by direct contact with a carrier of the fungus or through household items. For example, through shoes, socks, a towel, manicure supplies, rubber mats in the shower. In 70 - 95% of cases, the causative agent of mycosis of the feet is Trichophyton red (Tr. Rubrum).
Usually, infection occurs in public places with high humidity, where there are favorable conditions for the reproduction and spread of the pathogen. Such places include swimming pools, public showers, saunas, water parks, gym locker rooms. If a person infected with a fungus walks barefoot on the floor or rugs in the shower, he will leave infectious particles behind. And if then a healthy person steps into this place with bare feet, then the pathogen will fall on his skin. At the same time, the fungus does not always immediately manifest itself and causes the characteristic symptoms of the disease. With strong immunity, the absence of health problems, a person remains simply a carrier of the infection, but at the same time he does not get sick.
The risks of getting fungus and developing mycosis of the feet increase:
- damage to the integrity of the skin;
- violation of the blood supply to the extremities, in which the supply of oxygen and nutrients to the tissues worsens, regeneration processes slow down, local immunity is weakened;
- diabetes mellitus, high blood glucose levels create favorable conditions for the growth of the fungus, the progression of infection;
- excessive sweating;
- dry skin, which leads to microcracks;
- old age;
- blood diseases;
- long-term use of antibiotics, drugs that suppress immunity;
- vitamin deficiency;
- Wearing shoes that are breathable and create a greenhouse effect.
Symptoms and types of the disease
Mycoses of the feet manifest themselves in different ways, the symptoms are affected by the type of pathogen, the severity of the lesion. The first signs of the disease appear in the folds between the fingers, and from there spread to the plantar, lateral, back sides, and nails.
How the feet look with mycosis is shown in the photo.
When nails become infected, thickening, loss of gloss, clouding of the plate are noted. The nail acquires a yellow, gray tint, becomes fragile, crumbles.
Early clinical symptoms of mycosis of the feet include dryness, peeling of the skin, painless cracks in the folds between the toes. This form of the disease is called erased. Peeling and cracks at first do not cause pain, itching, or discomfort. Only a doctor can notice the first unexpressed signs of a fungal infection. In addition to the erased one, other clinical forms of mycosis of the feet are also distinguished, each of which has its own symptoms.
Squamous
In the squamous form of mycosis of the feet, there is peeling in the folds between the toes and on the sides. As a rule, there are no signs of inflammation. Redness, damage to the nails, itching, thickening of the stratum corneum, which gives the skin a shine, is possible. The papillary lines become more pronounced, and the surface of the skin becomes dry, covered with lamellar scales. In this case, the patient does not feel itching or other unpleasant sensations.
Hyperkeratotic
It appears as a rash on the vaults. The surface of the elements of the rash is covered with layered scales of gray-white color. There is a detachment of the epidermis, single vesicles. When merging with each other, the rashes form indistinct large foci that spread throughout the sole, including the lateral, dorsal surfaces. Along with the foci of peeling, there are areas of hyperkeratosis or thickening of the skin. They look like calluses with cracks on top. With a hyperkeratotic form of mycosis of the feet, the affected area is similar to the manifestations of psoriasis or eczema. A person is worried about dryness, itching, and sometimes pain.
Intertriginous
Intertriginous form of mycosis of the feet is similar to the symptoms of diaper rash. Hence the name from lat. intertrigo - "diaper rash". Most often, the skin is affected in the intervals between the third and fourth, fourth and fifth fingers. It becomes bright red, edematous. Weeping wounds, deep, painful cracks are formed. In contrast to diaper rash, lesions in intertriginous mycosis are round with clear outlines, a white contour separating along the edges of the epidermis. The person experiences itching, burning, soreness.
Dyshidrotic
Dyshidrotic forms of mycosis of the feet are characterized by multiple vesicles with a thick apex, located mainly on the arches. The rash spreads to large areas of the soles, as well as the spaces between the toes and the skin of the toes. Merge to form large bubbles. In place of the bursting bubble, wet erosion appears. As the inflammation increases, the skin turns red and swells. At the stage of vesicle formation, the patient feels unbearable itching.
Diagnostics
If you suspect mycosis of the feet, you need to go to a dermatologist. To confirm the diagnosis, the doctor will examine the legs, ask about what symptoms bother the person, how long ago and after which they appeared. Take a scraping from the affected area for microscopic analysis, cultural research to identify a specific type of pathogen. Additionally, your doctor may order blood tests.
How to treat mycosis of the feet?
Mycologist or dermatologist treats mycosis of the skin of the feet. Taking into account the clinical form of the disease, the severity of the lesion, the visible changes, the doctor will select an adequate therapy.
Complications of a mycotic infection on the legs may lead to infection with a fungus of the hands. Mycosis of the feet sometimes leads to secondary bacterial infections, especially when weeping wounds are present on the skin.
External fungicidal agents (ointments, creams), tablets for oral administration are prescribed to fight the fungus. Only local therapy is effective for milder forms of mycosis of the feet. According to clinical guidelines, oral medications are prescribed in severe cases.
If necessary, treatment is supplemented with anti-inflammatory, drying, antiseptic, anti-allergic drugs, agents that enhance the regeneration of damaged tissues. If there are signs of a bacterial infection, antibiotic therapy is prescribed.
With onychomycosis, hardware cleaning of the areas infected with the fungus is performed. For the subsequent processing of nails, local antifungal agents are prescribed: varnish, cream or ointment.
The duration of treatment is from two weeks to a month. If not only the skin is affected, but also the nails, the treatment is delayed. This is due to the fact that the nail grows slowly. To get rid of the infection, it is necessary for a completely healthy nail plate to grow back.
When the doctor's prescriptions are followed, mycosis can be successfully treated. But if, having noticed an improvement, the patient stops taking drugs, this leads to a return of the infection, its transition to a chronic form. It is necessary to complete the full course, even if the symptoms of the disease have already disappeared.
Very important in the treatment of mycosis of the feet foot care, personal hygiene, diet, selection of comfortable shoes that do not injure the affected areas.
What to do for prevention?
To avoid mycoses of feet and nails or reduce the risks of their development, the following recommendations will help:
- keep under control chronic diseases in which blood circulation in the lower extremities is impaired or the body's defenses are reduced;
- Wash your feet daily with soap and water, then dry them with a towel, especially the folds between the toes;
- ventilate your shoes and change socks daily;
- wear closed rubber slippers when visiting public showers, saunas, swimming pools, baths;
- in case of excessive sweating, use antiperspirants for feet, disinfectants for shoes, do not wear other people's shoes, socks, tights;
- do not use someone else's towel, washcloth.
If you find even slight peeling of the skin on your legs or cracks between your toes, it is worth getting tested for fungus. Early diagnosis and timely treatment will help to avoid complications, extensive damage, discomfort, pain when walking, and getting a bacterial infection.