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Background: Tinea pedis is one of the most prevalent superficial fungal infections. Initial antifungal treatment is often acquired over-the-counter (OTC) without previous consultation with a physician., Objective: Lately, increasing antifungal terbinafine resistance has been documented in Denmark and globally and it is therefore of interest to assess how Danish pharmacies advise customers with tinea pedis., Methods: One hundred Danish pharmacies were randomly selected and an employee interviewed from each. A structured question guide was followed, with the possibility to add further comments., Results: Interviews of 94 pharmacies were conducted. Six pharmacies never replied. Terbinafine as standard dose or cutaneous solution terbinafine one time application (Lamisil Once (R)) were recommended by 99% of the pharmacy employees as first-line treatment. The customer was advised to seek medical attention when tinea pedis was recurring (93%), or when treatment duration was > 2 weeks (77%). The majority (88%) of the pharmacy employees had no knowledge about antifungal resistance., Conclusion: Only few pharmacy employees were aware of the current problem of antifungal resistance and the majority advised costumers to initiate treatment using OTC topical terbinafine. The problem of emerging antifungal resistance requires attention in order to provide customers with tinea pedis effective treatment and prevent further societal spread of resistance to antifungals., (© 2024 The Author(s). Mycoses published by Wiley‐VCH GmbH.)

Background: Interdigital tinea pedis is the most common type of foot infection, which is often treated by topical or systemic antifungals. Due to the increase in antifungal resistance, antifungal socks are becoming potential alternatives for the daily management of tinea pedis., Methods: In this study, antifungal fibres were adopted to produce interdigital hygiene socks to split the third and fourth toe seams of the feet. In vitro antifungal activity was first examined to verify the effectiveness of the socks. Preventive efficacy against tinea pedis was then evaluated among healthy participants, followed by therapeutic effect detection in patients diagnosed with tinea pedis by analysing the improvement in total symptom scores (TTS)., Results: The interdigital-type hygiene socks exhibited apparent antifungal activities in vitro. An in vivo study demonstrated significant preventive effects against tinea pedis for interdigital socks compared to plain socks (P = 0.011) and a lower TTS than noninterdigital (P = 0.04) or plain socks (P < 0.0001). Moreover, interdigital socks showed a total effectiveness rate of 72.9% in patients with tinea pedis, with most of the symptoms alleviated., Conclusion: Interdigital-type hygiene socks not only exhibited in vitro antifungal activities but also showed significant prophylactic and therapeutic effects against interdigital tinea pedis in vivo., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Tinea pedis is a common condition seen in clinical practice and has a significant impact on quality of life. Recommendations of over-the-counter antifungal products based on consumer preferences may guide dermatologists in treating patients with tinea pedis and preventing onychomycosis recurrences. Our study aimed to determine consumer preferences of antifungal products for tinea pedis, focusing on features that may guide purchases and usage. A search was performed for antifungal products used to treat athlete's foot on Amazon.com as of 2018, and the top one percentile of over-the-counter products were sorted by rating and number of reviews. Functionality was the most cited positive feature (42% of comments) followed by cosmetic characteristics (14%). The median price of all products was $1.80 (range $0.33-$95.42), with solutions and balms associated with higher costs and soaks being the least expensive. Our study showed that the range of antifungal products available online for treatment and prevention of tinea pedis is large and variable in terms of type/vehicle, price, and ingredients. Physicians must counsel patients on the efficacy and Food and Drug Administration approval of listed ingredients, especially for those products associated with numerous supplementary claims.

Tinea pedis and onychomycosis often co-occur in individuals. A relationship between swimming pools and tinea pedis exists; however, little research has investigated the relationship between onychomycosis, tinea pedis, and swimming pools. This study sought to examine the prevalence of tinea pedis and onychomycosis among swimming pool employees, a population that may be at risk of tinea infections. Samples were taken from 169 employees at 21 swimming pools in the Netanya area, Israel. KOH microscopy and culture was used to identify fungi. About 46 % of swimming pool employees had concurrent tinea pedis and onychomycosis, 30 % had tinea pedis only, and 6 % had onychomycosis only, compared to 10, 8, and 8 % of controls, respectively. After adjusting for age and gender, swimming pool employees were 20× more likely to have concurrent tinea pedis and onychomycosis, 15× more likely to have tinea pedis only, and 3× more likely to have onychomycosis only compared to controls. The present results are in agreement with previous research and support that swimming pools remain an important source of fungal contamination. More attention to hygienic guidelines and preventative measures may be needed in these settings.

Athlete's foot is a fungal infection of the foot which causes dry, itchy, flaky condition of the skin caused by Trichophyton species. In this study, the potential of ultra-small nanostructured lipid carrier (usNLC)-based topical gel of miconazole nitrate for the treatment of athlete's foot was evaluated. Nanostructure lipid carriers (NLCs) prepared by melt emulsification and sonication technique were characterized for particle size, drug entrapment, zeta potential and drug release. The optimized usNLC revealed particle size 53.79 nm, entrapment efficiency 86.77%, zeta potential -12.9 mV and polydispersity index (PDI) of 0.27. The drug release studies of usNLC showed initial fast release followed by sustained release with 91.99% drug released in 24 h. Optimized usNLCs were incorporated into carbopol-934 gel and evaluated for pH (6.8), viscosity (36,400 mPa s) and texture analysis. Antifungal activity against Trichophyton mentagrophytes exhibited wider zone of inhibition, 6.6 ± 1.5 mm for optimized usNLC3 gel viz-à-viz marketed gel formulation (3.7 ± 1.2 mm). Hen's egg test-chorioallantoic membrane (HET-CAM) irritation test confirmed optimized usNLC gel to be non-irritant to chorioallantoic membrane. Improved dermal delivery of miconazole by usNLC gel could be achieved for treatment of athlete's foot.

Background: Interdigital tinea pedis is the most common type of foot infection, which is often treated by topical or systemic antifungals. Due to the increase in antifungal resistance, antifungal socks are becoming potential alternatives for the daily management of tinea pedis. Methods: In this study, antifungal fibres were adopted to produce interdigital hygiene socks to split the third and fourth toe seams of the feet. In vitro antifungal activity was first examined to verify the effectiveness of the socks. Preventive efficacy against tinea pedis was then evaluated among healthy participants, followed by therapeutic effect detection in patients diagnosed with tinea pedis by analysing the improvement in total symptom scores (TTS). Results: The interdigital-type hygiene socks exhibited apparent antifungal activities in vitro. An in vivo study demonstrated significant preventive effects against tinea pedis for interdigital socks compared to plain socks (P = 0.011) and a lower TTS than noninterdigital (P = 0.04) or plain socks (P

Allium cepa fractions have been shown to possess antifungal activity against Trichophyton rubrum. The antifungal effect of the plant is mainly attributed to the presence of Allicin. This study aims to formulate a topical antifungal gel and assess its physical stability and efficacy parameters against T. rubrum. The gel was formulated with various concentration of Allium cepa fractions FI (5%), F2 (7.5%), and F3 (12.5%). Each formulation was tested for physical stability and efficacy against T. rubrum. The agar well diffusion method was used to determine their antifungal activities using SDA plates. Furthermore, the antifungal activities were assessed by the presence or absence of inhibition zones after incubating the plates at 28°C for 7 days. The topical gel was a fawn-coloured homogenous semi-solid preparation that was readily spreadable upon skin contact with no tackiness sensation. The optimized gel showed no phase separation after the cycling test in six cycles (one cycle consists of temperatures of 4°C for 24 hours and 40°C for 24 hours). The efficacy test showed that the topical gel produced better inhibition zones against T. rubrum than the negative control. F3 (12.5%) showed the most inhibitory potentials of all the formulations (F1 and F2). These results demonstrate that Allium cepa fractions can be formulated into a stable semi-solid dosage form and with antifungal activity against T. rubrum. [ABSTRACT FROM AUTHOR]

Objective: To systematically review literature enabling the comparison of the efficacy of pharmaceutical treatments for tinea pedis in adults. Design: Systematic review of randomised controlled trials (RCTs) with mycological cure as the primary outcome. Secondary outcomes did include the clinical assessment of resolving infection or symptoms, duration of treatment, adverse events, adherence, and recurrence. Eligibility Criteria: Study participants suffering from only tinea pedis that were treated with a pharmaceutical treatment. The study must have been conducted using an RCT study design and recording age of the participant > 16 years of age. Results: A total of seven studies met the inclusion criteria, involving 1042 participants. The likelihood of resolution in study participants treated with terbinafine was RR 3.9 (95% CI: 2.0–7.8) times those with a placebo. Similarly, the allylamine butenafine was effective by RR 5.3 (95% CI: 1.4–19.6) compared to a placebo. Butenafine was similarly efficacious to terbinafine RR 1.3 (95% CI: 0.4–4.4). Terbinafine was marginally more efficacious than itraconazole, RR 1.3 (95% CI: 1.1–1.5). Summary/Conclusion: Topical terbinafine and butenafine treatments of tinea pedis were more efficacious than placebo. Tableted terbinafine and itraconazole administered orally were efficacious in the drug treatment of tinea pedis fungal infection. We are concerned about how few studies were available that reported the baseline characteristics for each treatment arm and that did not suffer greater than 20% loss to follow-up. We would like to see improved reporting of clinical trials in academic literature. Registration name: Treatment's for athlete's foot—systematic review with meta-analysis [CRD42020162078]. [ABSTRACT FROM AUTHOR]

Athlete's foot (Tinea pedis) and toe nails infection (onychomycosis) are disease conditions caused by dermatophytes; both diseases are prevalent in adults, especially in farmers who often wear robber shoes during farming. Proper treatment of dermatophytes related skin diseases needs a proper understanding of susceptibility of the causative agents to the intended treatment option. This knowledge can only be derived from proper identification and characterization of the related fungi. In the present study, both traditional and molecular identification approaches were applied on cultured samples for detection and identification of Tinea pedis. From the PCR analysis, Microsporum canis and Trichophyton mentagrophytes were identified as the two commonest species implicated in Tinea pedis basing on their DNA banding patterns. From the fifty two identified dermatophyte isolates via the conventional identification methods, only 45 isolates were confirmed via molecular approach, with 25 isolated being confirmed as M. canis while 20 isolates were T. mentagrophytes. The same was confirmed with real time PCR quantification. [ABSTRACT FROM AUTHOR]

Objective: To systematically review literature enabling the comparison of the efficacy of pharmaceutical treatments for tinea pedis in adults. Design: Systematic review of randomised controlled trials (RCTs) with mycological cure as the primary outcome. Secondary outcomes did include the clinical assessment of resolving infection or symptoms, duration of treatment, adverse events, adherence, and recurrence. Eligibility Criteria: Study participants suffering from only tinea pedis that were treated with a pharmaceutical treatment. The study must have been conducted using an RCT study design and recording age of the participant > 16 years of age. Results: A total of seven studies met the inclusion criteria, involving 1042 participants. The likelihood of resolution in study participants treated with terbinafine was RR 3.9 (95% CI: 2.0–7.8) times those with a placebo. Similarly, the allylamine butenafine was effective by RR 5.3 (95% CI: 1.4–19.6) compared to a placebo. Butenafine was similarly efficacious to terbinafine RR 1.3 (95% CI: 0.4–4.4). Terbinafine was marginally more efficacious than itraconazole, RR 1.3 (95% CI: 1.1–1.5). Summary/Conclusion: Topical terbinafine and butenafine treatments of tinea pedis were more efficacious than placebo. Tableted terbinafine and itraconazole administered orally were efficacious in the drug treatment of tinea pedis fungal infection. We are concerned about how few studies were available that reported the baseline characteristics for each treatment arm and that did not suffer greater than 20% loss to follow-up. We would like to see improved reporting of clinical trials in academic literature. Registration name: Treatment’s for athlete’s foot—systematic review with meta-analysis [CRD42020162078].

This article is aimed at providing a succinct overview of the condition tinea pedis, commonly referred to as athlete’s foot. Tinea pedis is a very common fungal infection that affects a significantly large number of people globally. The presentation of tinea pedis can vary based on the different clinical forms of the condition. The symptoms of tinea pedis may range from asymptomatic, to mild-to-severe forms of pain, itchiness, difficulty walking and other debilitating symptoms. There is a range of precautionary measures available to prevent infection, and both oral and topical drugs can be used for treating tinea pedis. This article briefly highlights what athlete’s foot is, the different causes and how they present, the prevalence of the condition, the variety of diagnostic methods available, and the pharmacological and non-pharmacological management of the condition.

This article is aimed at providing a succinct overview of the condition tinea pedis, commonly referred to as athlete's foot. Tinea pedis is a very common fungal infection that affects a significantly large number of people globally. The presentation of tinea pedis can vary based on the different clinical forms of the condition. The symptoms of tinea pedis may range from asymptomatic, to mild-to-severe forms of pain, itchiness, difficulty walking and other debilitating symptoms. There is a range of precautionary measures available to prevent infection, and both oral and topical drugs can be used for treating tinea pedis. This article briefly highlights what athlete's foot is, the different causes and how they present, the prevalence of the condition, the variety of diagnostic methods available, and the pharmacological and non-pharmacological management of the condition. [ABSTRACT FROM AUTHOR]

Background Diabetes patients are particularly susceptible to fungal infections because their vascular and immunological systems are compromised. Objectives The present study aimed to determine prevalences of tinea pedis and onychomycosis, factors predisposing to their development, and antifungal susceptibilities of causative fungal species against fluconazole, itraconazole, and terbinafine in patients with type 2 diabetes mellitus ( DM). Methods Study groups were defined according to hemoglobin A1C rates of ≥6.5% for the diabetes group and ≤5.7% for control subjects. A total of 600 diabetes subjects and 152 control subjects were evaluated. Rates of onychomycosis and tinea pedis in diabetes patients, and associations with age, gender, blood glucose level, duration of diabetes and serum lipid profile were investigated, as were the distribution and antifungal susceptibility of agents isolated. Results Patients with onychomycosis and/or tinea pedis numbered 85 in the diabetes group and nine in the control group ( P = 0.006). The development of onychomycosis or tinea pedis was significantly related to increasing age and male gender. Although the most common agents were dermatophytes, non-dermatophyte fungal isolates were not uncommon. Terbinafine was the most effective drug against dermatophytes but was invalid for non-dermatophyte isolates by in vitro antifungal susceptibility testing. Conclusions The development of onychomycosis or tinea pedis was significantly related to type 2 DM, increasing age, and male gender. The most common isolate was Trichophyton rubrum. The isolation and identification of the fungus is important to the effective management of tinea pedis and onychomycosis in diabetes patients because non-dermatophyte fungi can cause these infections. [ABSTRACT FROM AUTHOR]

Objective: Impaired cellular immunity and reduced phagocytic function of polymorphonuclear leukocytes facilitate the development of skin fungal and bacterial infections due to uncontrolled hyperglycemia in diabetic patients. In our study, we aimed to assess onychomycosis and/or tinea pedis frequency in diabetic patients, and effects on the development of chronic complications, particularly foot ulcer. Methods: We included 227 diabetic patients in the study. Forty-three patients had diabetic foot ulcer. We screened and recorded demographic characteristics, HbA1c levels of patients, and presence of complications We examined patients dermatologically, and collected samples by scalpel from skin between toes, and from sole, toe nail, and area surrounding nails from suspected to have fungal infection. Results: Native positivity between toes was higher in men compared to women (p<0.05). We obtained significant relation between HbA1c elevation and native positivity between toes (p<0.05). Fungal infection between toes, at sole and toe nail significantly increased in patients with diabetic foot ulcer compared to patients without diabetic foot ulcer (p<0.05). Moreover, native positivity in patients with diabetic foot ulcer correlated with presence of fungal infection examination findings (p<0.05). Conclusion: Fungal infections were more frequently observed in the presence of poor glycemic control and peripheral vascular disease in diabetic patients in compliance with the literature, and the presence of fungal infection may also responsible for the development of foot ulcers. [ABSTRACT FROM AUTHOR]

Background: Tinea pedis (TP) is an infection of the feet caused by fungi. The infectious diseases caused by dermatophytes are mainly related to the enzymes produced by these fungi. Up to the now, the local 8-iso-prostaglandin F2α (8-iso-PGF2α), concentration as oxidative stress biomarker and trace elements status have not been published in patients with TP. The aim of this study is to evaluate the relationship between oxidative stress and trace elements (Cu, Zn, Se), and to evaluate the ratios of Cu/Zn and Cu/Se in this disorder. Methods: Forty-three consecutive patients with a diagnosis of unilateral interdigital TP were enrolled in this study. The samples were obtained by scraping the skin surface. 8-iso-PGF2α concentrations in scraping samples were determined by ELISA. In addition, the levels of Se, Zn and Cu in scraping samples were determined on flame and furnace atomic absorption spectrophotometer using Zeeman background correction. Results: Oxidative stress was confirmed by the significant elevation in 8-iso-PGF2α concentrations (p < 0.05). When compared to non-lesional area, Zn and Se levels were significantly lower on lesional area, whereas Cu levels was higher on the lesional area than the non-lesional area (p < 0.05). In addition, the correlation results of this study were firstly shown that there were significant and positive correlations between Cu and 8-iso-PGF2α parameters, but negative correlations between Se-Cu; Se-8-iso-PGF2α parameters in lesional area. Furthermore, the ratios of Cu/Zn and Cu/Se were significantly higher on the lesional area than the non-lesional area (p<0.05). According to sex and fungal subtypes, there was no significant difference in the concentrations of 8-iso-PGF2α and trace elements in patients with TP (p > 0.05). Conclusions: Our results showed that there is a possible link between oxidative stress (increased 8-iso-PGF2α concentrations) and imbalanced of trace elements status in lesional area of TP patients. The use of antifungal agents together with both Zn and Se drugs could be helpful in the both regression of disease and in shortening the duration of disease. [ABSTRACT FROM AUTHOR]

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To derive a form of treatment forTinea pedis(also known as athlete’s foot), an attempt has been made to synthesize chitosan microcapsules that contain an antifungal agent using a coacervation technique. The antifungal agent, namely, clotrimazole, is encapsulated in different amounts: 25, 50, 75, and 100?mg. Optical and scanning electron microscopies demonstrate that the newly developed microcapsules have spherical core–shell forms with smooth surfaces and the particle sizes range from 2 to 10??m. It is observed that chitosan microcapsules with a drug input of 25?mg clotrimazole show the highest encapsulation efficiency when compared with microcapsules that have 50, 75, and 100?mg of drug input. An analysis of thein vitroantifungal activity confirms that the chitosan/clotrimazole microcapsules show obvious inhibition ofTrichophyton rubrumgrowth. The cytotoxicity results show that the newly developed microcapsules are non-cytotoxic to skin cell lines. The prepared drug-loaded microcapsules could be applied onto bandages or socks, and will continuously release antifungal drugs in a controlled manner under pressure. [ABSTRACT FROM AUTHOR]

The study aims to statistically develop a microemulsion system of an antifungal agent, itraconazole for overcoming the shortcomings and adverse effects of currently used therapies. Following preformulation studies like solubility determination, component selection and pseudoternary phase diagram construction, a 3-factor D-optimal mixture design was used for optimizing a microemulsion having desirable formulation characteristics. The factors studied for sixteen experimental trials were percent contents (w/w) of water, oil and surfactant, whereas the responses investigated were globule size, transmittance, drug skin retention and drug skin permeation in 6 h. Optimized microemulsion (OPT-ME) was incorporated in Carbopol based hydrogel to improve topical applicability. Physical characterization of the formulations was performed using particle size analysis, transmission electron microscopy, texture analysis and rheology behavior. Ex vivo studies carried out in Wistar rat skin depicted that the optimized formulation enhanced drug skin retention and permeation in 6 h in comparison to conventional cream and Capmul 908P oil solution of itraconazole. The in vivo evaluation of optimized formulation was performed using a standardized Tinea pedis model in Wistar rats and the results of the pharmacodynamic study, obtained in terms of physical manifestations, fungal-burden score, histopathological profiles and oxidative stress. Rapid remission of Tinea pedis from rats treated with OPT-ME formulation was observed in comparison to commercially available therapies (ketoconazole cream and oral itraconazole solution), thereby indicating the superiority of microemulsion hydrogel formulation over conventional approaches for treating superficial fungal infections. The formulation was stable for a period of twelve months under refrigeration and ambient temperature conditions. All results, therefore, suggest that the OPT-ME can prove to be a promising and rapid alternative to conventional antifungal therapies against superficial fungal infections. [ABSTRACT FROM AUTHOR]

There are discrepancies in the literature regarding the prevalence of tinea pedis in psoriasis. The aim of this investigation was to conduct a cross-sectional study of the prevalence of tinea pedis in psoriasis compared to atopic dermatitis patients and normal controls. We enrolled 232 psoriatic patients, 190 atopic dermatitis patients and 202 normal controls, between the years 2010 and 2013. The prevalence of tinea pedis was 13.8% in psoriasis patients, not significantly different from that in atopic dermatitis patients 8.4% ( P = 0.092)), but significantly higher than in normal controls 7.4% ( P = 0.043). Both gender and age affected the prevalence of tinea pedis in psoriasis and normal controls, while only age affected the prevalence of tinea pedis in atopic dermatitis. Regarding gender, there was higher prevalence of tinea pedis in men: 19.1% ( P = 0.019) in psoriasis and 12.1% ( P = 0.013) in normal controls. Age affected the prevalence of tinea pedis in normal controls ( P < 0.001), psoriasis patients ( P = 0.001) and atopic dermatitis patients ( P = 0.001), with higher prevalence with increasing age. Trichophyton rubrum was the most common species in psoriasis (71.9%), atopic dermatitis (75.0%) and normal controls (73.3%). Our study found a relatively high prevalence of tinea pedis among psoriasis patients. [ABSTRACT FROM AUTHOR]

Background: Tinea pedis is favored by occlusive shoes, sports and tropical climate that increases humidity and hyperhidrosis. The diagnosis is clinical and conirmed by KOH, an available and low cost test. The etiological agent is isolated by culture and usually belongs to three genders: Trichophyton, Microsporum and Epidermophyton. Objective: To know the prevalence of hyperkeratotic tinea of feet in a determined population. Material and method: An open, descriptive, observational, prospective and transversal study performed in the coast of the Gulf of Mexico, under predisposing conditions for the development of supericial mycoses. In the cases with clinical suspicion of tinea pedis a sample of squama was taken and all samples were submitted to the direct test with potassium hydroxide and culture on Sabouraud agar with antibiotics. Results: 621 patients with the irst consultation were studied. In 58 of them we observed suggestive data of tinea pedis, and in 18 cases the KOH was negative. The other 40 patients had clinical diagnosis of hyperkeratotic tinea pedis and were included in the study. Most of them reported that the lesions in the feet where the cause for their consultation, and the most frequent associated disease was onychomycosis. Cultures were positive in 5 cases, and Trichophyton rubrum was isolated in all of them. The most frequent concomitant diseases were overweight and obesity (47.5%), followed by diabetes mellitus type 2 (15%). Of the patients, 52.5% had personal history of tinea pedis, mostly intertriginous. Conclusions: Hyperkeratotic tinea pedis is the least diagnosed variety, probably because it is under reported. Despite the hot and humid weather in the studied area, we could not ind a signiicant relationship between the disease and the type of shoes, the method usually employed to dry their feet was the use of talc. [ABSTRACT FROM AUTHOR]

Objectives: Latino immigrant workers experience elevated rates of skin disease that result from their working and living conditions. Working in manual occupations exposes workers to a variety of challenges, including occlusive shoes, vigorous physical activity, and wet conditions. These challenges predispose workers to fungal infection. The objectives of this article are to examine the comorbidity of tinea pedis and onychomycosis and to identify possible risk factors among Latino immigrant poultry and nonpoultry workers in western North Carolina. Methods: Data were obtained from a cross-sectional study conducted between June 2009 and November 2010 in rural western North Carolina among 518 manual Latino immigrant workers to assess their occupational injuries. Participants completed a face-to-face interview and a dermatologic examination. Results: Nearly one-third of the participants (32%) were diagnosed as having onychomycosis and more than one-third (37.8%) were diagnosed as having tinea pedis. There was a greater prevalence of tinea pedis in men than women (71.3% vs 28.7%, respectively). Of the 518 participants, 121 (23.5%) had both conditions. Participants who reported the use of occlusive shoes as "always" or "most of the time" had a higher prevalence of comorbid onychomycosis and tinea pedis than the rest of the group. Conclusions: Comorbidity of tinea pedis and onychomycosis is common among immigrant Latino men and women who perform manual labor. Further studies confirming the presence and type of dermatophyte should be conducted. [ABSTRACT FROM AUTHOR]

We conducted a retrospective cohort study on clinical and mycological features of tinea pedis and tinea unguium in psychiatric inpatients in Japan. Of the 317 inpatients (152 with schizophrenia and 165 with depression), 46.1 % had tinea pedis and 23.7% had tinea unguium. Of those with tinea pedis, 48.6% also had tinea unguium. The most common clinical type of tinea pedis was the combination of interdigital type and hyperkeratotic type. The mean clinical score of tinea pedis was 5.9, and that of tinea unguium based on the Scoring Clinical Index for Onychomycosis(SCIO)was 15.8. The main causative species of tinea pedis were Trichophyton rubrum(68. 4%)and T. mentagrophytes(26.3%). No statistically significant differences were observed in incidence rates of tinea pedis or tinea unguium between men and women or between patients with schizophrenia and those with depression. As for incidence rates by age, patients with depression showed a single peak for tinea pedis and/or tinea unguium in their 50's, while patients with schizophrenia exhibited twin peaks for tinea pedis and/or tinea unguium in their 50's and 70's. Both tinea pedis and tinea unguium tended to become more severe in patients with chronic schizophrenia. Our study suggests that schizophrenia and depression, like diabetes mellitus and HIV infections, should be regarded as risk factors for tinea pedis and tinea unguium. [ABSTRACT FROM AUTHOR]

Background: Tinea pedis is the most common fungal infection especially prevalent in certain groups. The objective of this study was to determine the frequency of tinea pedis and its predisposing factors in the military recruits. Material & Methods: This cross-sectional study was conducted at Combined Military Hospital, D.I.Khan, from March 2012 to September 2012. A random sample of 350 individuals was selected out of individuals who were undergoing initial military training. Clinical examination, microscopic examination of scrapings from suspected lesions to see fungal hyphae and subsequent culture was done for species identification. Findings were recorded on a performa. Data was analyzed using SPSS version 10.0. Results: The mean age of subjects was 18.57±1.02 (16-23) years. On clinical examination tinea pedis was suspected in 34 (9.71%) out of 350 subjects. A total of 10 (2.8%) individuals were found to have positive fungal hyphae while 14 (4%) were culture positive for trichophyton. Out of 14 positive cultures, 8 yielded growth of Trichophyton mentagrophytes, 5 Trichophyton interdigitale and one yielded Trichophyton rubrum. Predisposing factors were occlusive footwear for >8 hours/ day in (96%), history of excessive sweating in (7.7%), history of fungal infection of feet during last 6 months in (3.4%) and fungal infection of nails during the last 6 months in (2.8%). Conclusion: The prevalence of tinea pedis in Pakistani military recruits is low. Occlusive footwear for more than 8 hours a day is the major risk factor . Excessive sweating and history of previous fungal infection are also risk factors. [ABSTRACT FROM AUTHOR]

Participation in competitive sports is popular and widely encouraged worldwide. Herein, we investigated 252 male and 67 female sports players, aged 16.4 ± 1.3 years, active in 15 different types of combat ( n = 143) and non-combat ( n = 176) sports. Of the 319 participants in this study, 11 (3.5%) players, including six wrestlers, four football players and one handball player, all of whom were men, harboured dermatophytic fungi. Briefly, Trichophyton tonsurans was present in three athletes, who were scalp carriers of the fungus. Furthermore, T. rubrum (4), T. interdigitale (3) and Arthroderma simii (1) were recovered from eight participants with tinea inguinalis (4), tinea pedis (2) or both (1). One patient was a trunk carrier of concomitant tinea pedis. All dermatophytic fungi were identified using both direction sequence of the rDNA regions spanning the internal transcribed spacers (ITS1 and ITS2) and 5.8 rRNA gene. Although sports-active individuals are active and sweat more, we observed a low prevalence of dermatophytosis, both in combat (5.2%) and non-combat sports participants (3.4%) ( P > 0.05). However, dermatophyte infections require more attention and appropriate management to eradicate the infection and to prevent possible outbreaks. This study also documents the first case of zoophilic A. simii in Turkey. [ABSTRACT FROM AUTHOR]

Dermatophytoses are a widespread problem worldwide. Textiles in contact with infected skin can serve as a carrier for fungus propagation. Hitherto, it is unknown, whether antifungal textiles could contribute in controlling dermatophytes e.g. by disrupting the chain of infection. Testing of antimicrobial fabrics for their antifungal activities therefore is a fundamental prerequisite to assess the putative clinical relevance of textiles for dermatophyte prevention. Fabrics finished with either didecyldimethylammonium chloride (DDAC), poly-hexamethylenbiguanide, copper and two silver chloride concentrations were tested for their antifungal activity against Trichophyton rubrum, Trichophyton mentagrophytes and Candida albicans. To prove dermatophyte susceptibility towards the textiles, swatches were subjected to DIN EN 14199 ( Trichophyton sp.) or DIN EN ISO 20743 ( C. albicans) respectively. In addition, samples were embedded, and semi-thin sections were analysed microscopically. While all samples showed a clear inhibition of C. albicans, activity against Trichophyton sp. varied significantly: For example, DDAC completely inhibited T. rubrum growth, whereas T. mentagrophytes growth remained unaffected even in direct contact to the fibres. The results favour to add T. mentagrophytes as a test organism in textile dermatophyte efficacy tests. Microscopic analysis of swatches allowed detailed evaluation of additional parameters like mycelium thickness, density and hyphae penetration depth into the fabric. [ABSTRACT FROM AUTHOR]

Objective: Tinea pedis is the most common superficial fungal infection of the foot. Although light microscopic characteristics of tinea pedis have already been described and are well known, electron microscopic data is still lacking. In this study, we aimed to examine the ultrastructural changes in the epidermis of patients diagnosed with tinea pedis. Material and Methods: Biopsies were taken from the lesions between the toes of patients with untreated tinea pedis and from healthy volunteers with no fungal infections. The materials obtained were prepared for electron microscopy and examined by transmission electron microscope. Results: The ultrastructural examination revealed the following changes: (1) Disturbances in the form and organization of keratinocytes; (2) Irregular dis-tribution and interlacing of tonofilament bundles in keratinocytes; (3) Disruption of desmosomes and detachment of adjoining keratinocytes; (4) Exces-sive widening of intercellular spaces between keratinocytes; (5) Dilatation of intercellular spaces between basal cells; (6) Degranulation of melanocytes in the stratum basale; (7) Migration of lymphocytes and polymorphonuclear leukocytes between keratinocytes in the stratum spinosum; (8) Degradation of basal lamina; (9) Pericapillary edema in the apillary dermis. [ABSTRACT FROM AUTHOR]

In the developed countries infections of the feet (tinea pedis, athlete's foot) and nails (onychomycosis) with the anthropophile fungus Trichophyton rubrum are most common. We examined the propagation of dermatophytes before and during domestic laundering. About 10% of the infectious material was transferred from contaminated textiles to sterile textiles during storage in a clothes basket simulation indicating a high infection risk during storage. This was evaluated with two quantification techniques: cultivation with subsequent colony counting and tracing of radioactively labelled propagating units. Both approaches reliably revealed similar results with the latter method reducing experimental time to few minutes compared to 2 weeks with the traditional method. The tracer technique allowed favourably to directly reflect the textile-bound infectious material at the moment of skin contact. To address the infection risk during domestic laundry, bioindicators with T. rubrum or the yeast Candida albicans were introduced into common domestic washing procedures with different temperature courses. While C. albicans did not survive any of the tests, T. rubrum could be recovered after washing at 30°C, indicating the risk potential of dermatophyte infections at home. Up to 16% of the initial fungus load was detected in the rinsing water. Washing at 60°C however, eliminated both pathogens, T. rubrum and C. albicans. [ABSTRACT FROM AUTHOR]

Tinea pedis, also known as athlete’s foot, represents the fungal infection of the foot. It is a common condition among adults, having specific clinical manifestations, but it can also develop asymptomatic. Therefore, it is important that the family doctors assess patients' feet completely and correctly, looking for signs of infection. Beside the antifungal therapy with curative intent, it is necessary to offer all the information necessary to patients on how to prevent new dermatophytic infections. [ABSTRACT FROM AUTHOR]

Background Onychomycosis is a common cause of nail dystrophy and may be associated with tinea pedis. The presence of dermatophyte fungi in clinically normal nails is unknown. Objectives To assess the presence of dermatophyte fungi in normal-appearing toenails and to compare the risk of subclinical dermatophytosis in patients without and with concurrent tinea pedis. Methods This is a prospective, University-based study of adults without and with microscopically confirmed tinea pedis. Subjects with dystrophy of any toenail were excluded, as were those ever previously diagnosed as having onychomycosis and those who had used topical antifungals in the past year. A great toenail clipping obtained from each subject was submitted for periodic acid–Schiff histology. Results One hundred and one subjects (63 men and 38 women, mean ± SD age 45·4 ± 15·7 years) were included. Overall, septate hyphae (ostensibly dermatophyte) were identified in seven specimens. Of the 66 control subjects, one case (1·5%) of nail dermatophyte was identified. Of the 35 subjects with tinea pedis, six cases (17%) of nail dermatophyte were identified ( P = 0·0066; odds ratio 13·4, 95% confidence interval 1·6–117). There were no significant differences in age or gender between the experimental and control groups or between the nail dermatophyte-positive and negative cohorts. Conclusions Dermatophyte fungi may be isolated from normal-appearing toenails. The presence of dermatophytes in this situation is strongly associated with the presence of tinea pedis. Subclinical dermatophyte in the nail plate may serve as a reservoir for ongoing local infection. [ABSTRACT FROM AUTHOR]

Background: In the treatment of tinea pedis, current terbinafine formulations are applied once or twice daily for 7 days. A terbinafine emulsion gel formulation has been developed to provide a 5-day treatment course for tinea pedis. Objective: To determine the lowest effective concentration of terbinafine (1% or 3%) emulsion gel applied once daily for 5 days for the treatment of tinea pedis. Methods: This double-blind, placebo-controlled study evaluated the efficacy of 1% and 3% terbinafine gel for 5 days in 84 outpatients with tinea pedis. The primary efficacy endpoint was the percentage of patients with effective treatment (negative microscopy and culture with only mild erythema/desquamation/pruritus [total score≤2]) at study endpoint (last post-baseline observation up to and including week 6). Results: Efficacy rates with terbinafine 1% and 3% emulsion gel were significantly higher than with placebo (86% and 68% vs 11%, respectively; p<0.001). Similarly, mycological cure rates were significantly greater with terbinafine 1% and 3% gel (97% and 89%, respectively) than with placebo (22%; p<0.001). Conclusions: Terbinafine 1% emulsion gel used once daily for 5 days was the lowest effective concentration, and was significantly superior to placebo. Both concentrations were effective and safe, providing convenient, short-duration treatment of tinea pedis. [ABSTRACT FROM AUTHOR]

A new, single-application formulation containing terbinafine has recently been approved for the treatment of athlete's foot. An expert panel of dermatologists was convened to provide guidance on the important attributes of this new film-forming solution (FFS), how best to inform potential users on these benefits and how to ensure appropriate use. A consumer survey about tinea pedis revealed an average disease duration of 7 years, an average of four recurrences per year, patient concerns about itching and foot odor, but a poor level of patient knowledge on the cause of tinea pedis and available treatments. A review of the clinical trial data that led to the successful registration of the FFS demonstrated that treatment was both effective and well tolerated. The panel also considered data supporting the treatment of the entire lateral and undersurface areas of both feet, rather than lesions that are just symptomatic, usually the interdigital spaces, as previously recommended, and discussed guidelines for use of the new formulation. Discussion focused on the value of single-dose treatment in addressing noncompliance with treatment for the correct duration, guidelines for treatment of both feet and the need for an educational program on the FFS for dermatologists and pharmacists, and appropriate instructions for patients. The panel concluded that new single-dose therapy with terbinafine FFS presents a novel treatment opportunity owing to its simplicity of application. This provides an opportunity to develop new ways of increasing interaction between dermatologists, pharmacists, scientific/news media and patients, so that there is full understanding of the value of the new treatment. [ABSTRACT FROM AUTHOR]

The article elaborates the survey regarding prevalence of tinea pedis in professional and college soccer players compared to non-athletes in the United States. The objective of the study is to assess the prevalence of various risk factors and their association with tinea pedis among these three groups of people. Tinea pedis infected 69 percent professional soccer players compared with 69 percent of male college soccer players and 43 percent of female college players. The non-athletes demonstrated less tinea pedis.

Background Tinea pedis is a common dermatophyte infection with frequent recurrences. Terbinafine (presently used as a 1-week topical treatment of tinea pedis) is now available in a novel topical solution (film-forming solution – FFS), developed to allow single application. Objectives To demonstrate the efficacy and safety of terbinafine 1% FFS in a randomized, double-blind, placebo-controlled, phase III trial, and to determine relapse or re-infection rate of tinea pedis at 12 weeks. Patients/methods Fifty-four centres (27 in France; 27 in Germany) enrolled 273 evaluable patients (2 : 1 randomization). Patients applied terbinafine 1% FFS or placebo only once between, under and over the toes, soles and sides of both feet. Efficacy assessments included direct microscopy, mycological culture, and clinical signs and symptoms at baseline, and at weeks 1, 6 and 12 after the single drug application. Results Effective treatment (negative mycology plus absent/minimal symptoms) at week 6 in the terbinafine 1% FFS group was 63%; vehicle was 17% ( P  0.0001). Mycological cure was 72% in the terbinafine group and 21% in the placebo ( P  0.0001) at week 6. Clinical signs/symptoms decreased significantly in the active group compared to the placebo. The self-assessment of itching and burning sensation by the patient showed a clear reduction in symptoms starting 15 min after treatment application (this could be attributed to the cooling effect of the FFS). Recurrence (positive culture at 3 months) occurred in 12.5% of the effectively treated patients at week 6 in the terbinafine group. FFS was well tolerated. Conclusion Terbinafine 1% FFS, single dose application is an effective, safe and convenient treatment for tinea pedis. The relapse/re-infection rate 3 months after the end of single-dose therapy is similar to that previously demonstrated in a study using terbinafine 1% cream for 7 days. [ABSTRACT FROM AUTHOR]

Tinea pedis is contagious and typically spreads from infected to non-infected persons. The purpose of this study was to evaluate the efficacy of footwear in preventing tinea pedis adhesion. Using the stamp culture method, we investigated the effectiveness of preventing dermatophyte passage by the wearing of stockings made of nylon, socks made of cotton and tabi (Japanese socks), as well as the effect of removing dermatophytes from these items by washing with soap, cold water and cold water after turning inside-out. For sandals, sneakers and boots, we also investigated the effect of dermatophyte removal by pouring cold water into the footwear, wiping with a wet towel, and pouring boiling water into the footwear. The wearing of socks or tabi was effective in preventing passage of dermatophytes. The stocking material proved to be too thin to prevent passage. On the inner side of socks (the side of the sole ), all treatments were effective at removing dermatophytes, but on the outer side of socks (the side touching the surface of the sandals ), the treatment of washing in cold water after turning inside-out resulted in significantly more dermatophytes as compared with the other treatments. Pouring cold water, wiping with a wet towel and pouring boiling water were all effective for removing dermatophytes from sandals and sneakers. However, for boots, the treatment of pouring cold water was less effective. To prevent the adhesion of dermatophytes to sandals, wearing socks or tabi was effective, and the treatments of washing socks in cold water after turning inside-out and of pouring cold water into the boots were less effective than the others. [ABSTRACT FROM AUTHOR]

Epidemiological studies on tinea pedis and onychomycosis, common fungal infections, have been conducted in many parts of the world. There are currently no studies of tinea pedis and/or onychomycosis in Algeria. The aim of this paper was to study the epidemiology of foot diseases, including tinea pedis and onychomycosis and to identify the aetiological factors of these infections in outpatients attending the Department of Dermatology of the Central Hospital of Army in Algiers, Algeria. A total of 1300 male subjects, mean age 35.9 ± 16 years (range: 16–80) were recruited during the period November 2003 to November 2004 and were clinically examined. A complete dermatological examination was performed on all subjects, and skin and nail specimens of the feet were taken from those patients presenting signs of tinea pedis and/or onychomycosis for microscopy and fungal culture. Clinical diagnosis for tinea pedis and onychomycosis was suspected in 249 and 72 subjects, respectively, and confirmed in 197 and 60 cases, respectively, by positive cultures, resulting in a global prevalence of tinea pedis and toenail onychomycosis of 15% and 4.6% respectively. The age groups most commonly infected were 50–59 and 20–29 years. The yeast species Candida parapsilosis and the dermatophytic species Trichophyton rubrum were shown to be the most common pathogens in both tinea pedis ( C. parapsilosis 20.4%; T. rubrum 17%) and onychomycosis ( T. rubrum 35%; C. parapsilosis 28.3%). This is the first investigation dealing with fungal foot diseases in Algeria. The clinical and epidemiological data collected would serve as reference for future research and may be useful in the development of preventive and educational strategies. [ABSTRACT FROM AUTHOR]

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Objectives The aim of this study has been to evaluate patients with tinea pedis for their demographic data and attitudes affecting the treatment of disease, and to compare the in vitro activity of 10 antifungal agents and to relate them to their in vivo activity. Methods Patients with positive mycological examination were enrolled in the study, and a questionnaire comprised of 22 questions was administered. A mycological culture was carried out for each specimen. The antifungal susceptibility of the subcultured species was determined for griseofulvin, terbinafine, ciclopiroxolamine, fluconazole, ketoconazole, itraconazole, bifonazole, sulconazole, oxiconazole and miconazole with microdilution. Results Mycological cultures were carried out from 59 patients and there were 35 positive cultures (59.3%). The dermatophytes were Trichophyton rubrum ( n = 25) and Trichophyton mentagrophytes ( n = 3). The yeasts were Candida albicans ( n = 7), Candida glabrata ( n = 1) and Trichosporon ( n = 2). In the minimum inhibitory concentration (MIC) study, the mean ± standard error of the mean (SEM) MICs of the antifungals for T. rubrum were as follows: terbinafine 0.01 ± 0.003, oxiconazole 0.16 ± 0.05, sulkonazole 0.31 ± 0.05, miconazole 0.45 ± 0.15, itraconazole 0.74 ± 0.01, ketokonazole 1.03 ± 0.17, ciclopiroxolamine 1.30 ± 0.12, bifonazole 1.94 ± 0.51, griseofulvin 4.87 ± 0.61, and fluconazole 17.91 ± 3.67 µg/mL. Conclusion Our study supports that azoles could be used as first-line treatment, as oxiconazole is very effective for both dermatophytes and C. albicans. Correlation between in vitro results and clinical outcomes of cases of dermatophytes is still to be established and interpretive breakpoints defined, in order to increase the quality of patient care in tinea pedis. [ABSTRACT FROM AUTHOR]

Evaluates the efficacy of using topical or oral antifungal agents to treat fungal infections of the feet in diabetic patients. Fungi that cause tinea pedis; Topical antifungals being used to treat mild tinea pedis in adults; Comparison of some features of selected oral antifungal agents used to treat moderate-to-severe tinea pedis and pedal onychomycosis.

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Tinea pedis is a dermatophytic infection with a high prevalence in adults and also occasionally observed in children. We report here two cases of bullous tinea pedis, one due toTrichophyton rubrumin a 6-year-old child and the second due toT. interdigitalein a 10-year-old child. We suggest that, despite the low prevalence of this infection in childhood, a potassium hydroxide test and a culture for fungi should always be performed when a child is examined for an inflammatory eruption of the feet. [ABSTRACT FROM AUTHOR]

Dermatophyte infections have been considered rare in psoriasis. However, there are data indicating that tinea unguium is as common or even more common in psoriasis compared with healthy controls. Tinea unguium is generally a secondary event to tinea pedis infection. To study the prevalence of tinea pedis and tinea unguium in psoriasis compared with a control group. Consecutive psoriasis outpatients aged 18–64 years attending a department of dermatology were examined. Samples for direct microscopy and culture were taken from the interdigital spaces, soles and toenails. Consecutive patients without signs of psoriasis or atopic dermatitis seeking examination of moles constituted the control group. In total, 239 patients with psoriasis and 245 control patients were studied. The prevalence of tinea pedis was 8·8%[95% confidence interval (CI) ± 3·6%] in the psoriasis group and 7·8% (95% CI ± 3·4%) in the control group. The corresponding figures for prevalence of tinea unguium were 4·6% (95% CI ± 2·7%) and 2·4% (95% CI ± 1·9%), respectively. The differences found in the psoriasis vs. the control groups were not statistically significant. This study does not support the hypothesis that the prevalence of tinea pedis and tinea unguium in patients with psoriasis differs from that in a normal population. [ABSTRACT FROM AUTHOR]

Summary In this study, we investigated epidemiological and clinical aspects of dermatophyte foot infections among employees of one dairy product company located in Kanagawa prefecture in central Japan. Sixty-nine of 377 subjects were reported having “athlete's foot” in response to a simple questionnaire. A subsequent mycological examination revealed 41 untreated patients with tinea pedis and/or tinea unguium (89% of subjects examined) and the overall prevalence was estimated at 18%. Comparing severity scores of five clinical symptoms (itching, erythema, vesicles/pustules, erosion/maceration, and scales) between those untreated patients within the subjects and another group of patients who spontaneously attended dermatological clinics to treat tinea pedis, itching, erythema, and total score were significantly higher in the latter group. [ABSTRACT FROM AUTHOR]

Summary The aim of this study was to verify the incidence of tinea pedis in patients observed in the Department of Dermatology of the University of Cagliari, Italy, in the period from 1996 to 2000. We examined 722 patients, 536 with lesions and 186 without lesions of the feet and in 169 of them (23.4%) we diagnosed tinea pedis. All patients suffering from tinea pedis belonged to the group with lesions. In the 536 patients with clinical manifestations which were evident to a certain degree, microscope and cultural examination gave positive results for dermatophytes in 169 cases (31.5%). The most frequently isolated dermatophyte was Trichophyton mentagrophytes (51.5%), followed by Trichophyton rubrum (45.2%) and Epidermophyton floccosum (3.3%). In the 186 patients without lesions, direct microscope examination was consistently negative while cultural examination showed the growth of sparse colonies of Candida albicans in two cases (1.1%) We analysed distribution by sex, age, residence, occupation and clinical manifestations. Stressing the high frequency of tinea pedis in this region, the discovery of a dermatophytic infection of the feet with an absence of signs and symptoms is an exceptional event. [ABSTRACT FROM AUTHOR]

Summary. A cross-sectional study was performed in two primary schools with different socioeconomic status in the suburban and central areas of Manisa, Turkey, in order to determine the prevalence of tinea pedis and onychomycosis. A full dermatological examination and a questionnaire on socioeconomic conditions were performed in agroup of 785 randomly selected children aged 6–14. Of 9 clinically suspected tinea pedis and 4 onychomycoses cases, KOH examination (direct microscopy) and/or mycological cultures were positive in six boys, in whom Candida glabrata and C . tropicalis grew. Older age and higher number of siblings were found to be significant factors for fungal infection. Zusammenfassung. In zwei Grundschulen mit unterschiedlichem sozio-ökonomischen Status in Umgebung und Zentrum von Manisa (Türkei) wurde die Häufigkeit von Tinea pedis und Nagelmykosen untersucht. Eine ausführliche dermatologische Untersuchung und Befragung der sozio-ökonomischen Bedingungen wurde bei 785 willkürlich ausgesuchten Kindern im Alter 6–14 Jahren durchgeführt. Von 9 Schülern mit Tinea pedis und 4 Schülern mit Nagelmykosen waren 6 Jungen im KOH-Test und/oder mykologischer Kulturuntersuchung positiv, bei denen Candida glabrata und C . tropicalis isoliert wurden. Höheres Alter und Geschwisterzahl waren wichtige Risikofaktoren. [ABSTRACT FROM AUTHOR]