Treatment of fungal foot infections
Fungal foot infections or Tinea pedis rarely causes significant morbidity and certainly not mortality, but there is some evidence that it acts as a portal of entry for bacteria that produce bacterial cellulitis. Topical antifungal treatment (with topical azoles or allylamines) of tinea pedis is generally adequate, as it is for small areas of tinea corporis and cruris, but for extensive infections, and especially those in immunosuppressed patients, oral therapy may be required. Several antifungal topical therapies are available without prescription, and the vast majority of the disease burden is likely to be managed without intervention from medical personnel. However, relapse from inadequate therapy is a common event in tinea pedis, albeit less so in other body sites. Reinfection can also occur in about 10% of cases. Certain clinical forms of tinea pedis are more resistant to treatment and may require oral therapy with systemic antifungals such as terbinafine, fluconazole, or itraconazole. Severe macerated forms of tinea pedis may well be superinfected with bacteria justifying concomitant antibiotic therapy, although some topical antifungal agents have in vitro antibacterial activity, such as ciclopiroxolamine.