Athlete's foot

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Classification according to ICD-10
B35.3 Tinea pedis
ICD-10 online (WHO version 2019)
Athlete's foot (interdigital form)

The Athlete's foot is a fungal infection of the feet by filamentous fungi ( dermatophytes ). These fungi attack horny substances such as skin, hair and nails. With athlete's foot, a distinction is made between three different forms of disease:

  2. Infection of the spaces between the toes (interdigital: tinea pedis interdigitalis, interdigital mycosis) , the most common form usually between toes four and five.
  4. on the sole of the foot (squamous-hyperkeratotic: tinea pedis, also tinea pedum) and
  6. in the arch of the foot (vesicular-dyshidrotic) .

root cause

Athlete's foot is caused by filamentous fungi ( dermatophytes ) that attack the horny material (nails, hair) and mainly settle in the spaces between the toes. Mostly Epidermophyton floccosum , but recently Trichophyton rubrum or Trichophyton interdigitale are the most common triggers. However, individual factors play a major role in the development of athlete's foot. Internal (endogenous) disposition factors can be, for example, metabolic diseases and immune deficiencies . For example, patients with diabetes mellitus and circulatory disorders have an increased risk of athlete's foot or nail fungus . However, the cause can also be longer antibiotic therapy.

The athlete's foot is actually harmless to humans. But the untreated infection can weaken the natural defenses of the skin to such an extent that there is a streptococcal infection by an erysipelas noticeable. This is a serious skin infection that can be accompanied by a high fever and requires inpatient treatment. In addition, athlete's foot favors nail fungus infection if there are cracks or open areas on the toenails at the time of the disease.

transmission

Athlete's foot pathogens are transmitted indirectly from person to person via contact or smear infection via walking surfaces and objects infected with the pathogens or directly through contact with an infected foot of another person.

Indirect infection is possible wherever people walk barefoot in warm and humid environments who would not otherwise - for example in swimming pools , public showers or saunas . A damp environment in shoes, caused by foot sweat, insufficient drying or too tight shoes, promotes athlete's foot infection. In addition to diabetics, people with a misalignment of the foot, which leads to particularly tight spaces between the toes, are at risk.

Symptoms

Typical symptoms of athlete's foot are redness , oozing, flaking , blistering and itching , often accompanied by inflammation .

diagnosis

Athlete's foot infections are generally easy to spot and diagnose by the course of the disease and the appearance of the feet. However, not only should the disease itself be recognized, but the exact type of pathogen should also be identified in order to ensure appropriate treatment. A skin sample is taken, which the doctor scrapes off the affected area using a spatula or scalpel . A potassium hydroxide solution can be added to this, which dissolves the skin cells and leaves only the hyphae behind. By examining the sample under a microscope, the doctor can identify a possible fungal infection. In rare cases, a fungal culture or a histological examination may be necessary. A Wood lamp can be used to differentiate it from other infections .

therapy

If there is inflammation, it is treated first, then the fungus is treated topically with an antifungal agent in the form of a spray, ointment, cream or powder. The duration of the local treatment should be an additional 3-4 weeks after clinical healing, but only 7 days for terbinafine . Systemic antimycotics are also used if the symptoms persist or if the disease spreads too far . After the treatment, preventive measures are recommended, such as keeping your feet clean and dry and disinfecting worn stockings and shoes.

Portuguese researchers were able to show that lavender oil kills various yeast ( Candida species ) and filamentous fungi, which can cause skin and nail fungal diseases in humans, even in low concentrations . When tea tree oil is used externally, good treatment results have been reported due to its fungicidal effect, among other things . Other essential oils are also used in alternative medicine.

prevention

The most important preventive measure is to dry your feet completely after showering, bathing, going to the swimming pool and the like before putting on shoes again. Alternatively, you can do without shoes for the time being. Bathing shoes , on the other hand, are ineffective or even counterproductive, as the foot no longer comes into contact with the ground, but still with sloshing water. In addition, spores that are once in these shoes can hold up there particularly well.

For people who go barefoot for long periods of time, it is almost impossible to contract athlete's foot, as the necessary moist foot climate is lacking. Athlete's foot spores are no longer detectable on textiles after a 60 ° wash.

research

The use of low-temperature plasma (TTP) is a technology for disinfection with cold plasma , which can also kill antibiotic- resistant pathogens even through clothing at a temperature of below 100 ° C. It is suitable, for example, for disinfecting air, surfaces, objects, hand disinfection and the treatment of poorly healing chronic wounds . In in vitro tests, not only a killing effect against bacteria, but also against viruses and fungi could be observed. Treatment with TTP for mycoses as well as athlete's foot therefore appears possible, but this has yet to be confirmed by further studies.

literature

  • Peter Altmeyer, Martina Bacharach-Buhles: Encyclopedia of Dermatology, Venereology, Allergology, Environmental Medicine. Volume 2: M - Z. 2nd, completely revised edition. Springer, Berlin / Heidelberg 2010, ISBN 978-3-540-89543-5 , chapter: Tinea pedum ( online ).
  • Herbert Gebler, Gerd Kindl (ed.): Pharmacy for practice: a textbook for the 3rd phase of training; a manual for the pharmacy. 6th, completely revised edition. Deutscher-Apotheker-Verlag, Stuttgart 2013, ISBN 978-3-7692-4790-9 , chapter: Means against fungal diseases .

Web links

Wiktionary: athlete's foot  - explanations of meanings, word origins, synonyms, translations
Commons : Athlete's foot  - collection of images, videos and audio files

Individual evidence

  1. ↑ a b c guideline tinea of ​​free skin . ( Memento from January 24, 2013 in the Internet Archive ; PDF; 209 kB) German Dermatological Society
  2. ↑ Irene Weitzman, Richard S. Summerbell: Dermatophytes. In: Clinical Microbiology Revies. (Clin. Microbiol. Rev.) No. 8, April 1995, pp. 240-259, PMC 172857 (free full text).
  3. ^ Medicine - The fungus people . In: Der Spiegel . No. 1 , 2000 ( online ).
  4. ↑ a b c Siegfried Bäumler: Medicinal Plant Practice Today. Volume 2: Recipes and application. 2nd Edition. Elsevier + Urban & Fischer, Munich 2013, ISBN 978-3-437-57273-9 , p. 409 ( limited book review on Google Books ).
  5. ↑ Muhannad Al Hasan, S. Matthew Fitzgerald, Mahnaz Saoudian, Guha Krishnaswamy: Dermatology for the practicing allergist: Tinea pedis and its complications . In: Clinical and Molecular Allergy . tape 2 , no. 5 , March 29, 2004, ISSN  1476-7961 , doi : 10.1186 / 1476-7961-2-5 , PMID 15050029 , PMC 419368 (free full text).
  6. ↑ M. Zuzarte, MJ Goncalves et al. a .: Chemical composition and antifungal activity of the essential oils of Lavandula viridis L'Her. In: Journal of Medical Microbiology. 60, 2011, pp. 612-618, doi: 10.1099 / jmm.0.027748-0 .
  7. ^ A. Angioni, A. Barra, V. Coroneo, S. Dessi, P. Cabras: Chemical composition, seasonal variability, and antifungal activity of Lavandula stoechas L. ssp. stoechas essential oils from stem / leaves and flowers. In: Journal of agricultural and food chemistry. Volume 54, Number 12, June 2006, pp. 4364-4370, doi: 10.1021 / jf0603329 , PMID 16756368 .
  8. ↑ M. Zuzarte, MJ Gonçalves, C. Cavaleiro, AM Dinis, JM Canhoto, LR Salgueiro: Chemical composition and antifungal activity of the essential oils of Lavandula pedunculata (Miller) Cav. In: Chemistry & biodiversity. Volume 6, Number 8, August 2009, pp. 1283-1292, doi: 10.1002 / cbdv.200800170 , PMID 19697345 .
  9. ↑ Peter Altmeyer, Martina Bacharach-Buhles: Encyclopedia of Dermatology, Venereology, Allergology, Environmental Medicine. Volume 2: M-Z. Chapter: Tinea pedum.
  10. ↑ Andrew C. Satchell, Anne Saurajen et al. a .: Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: a randomizeid, placebo controlled blinded study. In: Australasian Journal of Dermatology . Volume 43, No. 3, 2002, pp. 175-178, doi: 10.1046 / j.1440-0960.2002.00590.x
  11. ↑ Does athlete's foot also lurk in the laundry basket? (PDF; 20 kB) Hohenstein Institute , press release, March 17, 2010.
  12. ↑ GE Morfill, MG Kong, JL Zimmermann: Focus on Plasma Medicine. In: New Journal of Physics , 2009, Volume 11, Article 115011, doi: 10.1088 / 1367-2630 / 11/11/115011 ; ( iop.org ; PDF).
  13. ↑ Martin C. Klebes: Dermatological application of an electrical plasma at body temperature. Dissertation, Institute / Clinic for Dermatology, Venereology and Allergology of the Medical Faculty Charité - Universitätsmedizin Berlin, Berlin September 4, 2015, p. 16; diss.fu-berlin.de (PDF).
  14. ↑ J. Heinlin, G. Isbary, W. Stolz, G. Morfill, M. Landthaler, T. Shimizu and others. a .: Plasma applications in medicine with a special focus on dermatology. In: Journal of the European Academy of Dermatology and Venereology: JEADV. (J Eur Acad Dermatol Venereol) 2011, Volume 25, No. 1, pp. 1-11, doi: 10.1111 / j.1468-3083.2010.03702.x .