Why Are Mycosis of the Feet so Common and Difficult to Treat?


28.05.2019
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Foot mycoses are fungal diseases combined into one group of ringworm, as they are prone to damage of the same areas of the body, namely the feet, nails, heels and interdigital folds. Dermatomycoses occupy the second place in terms of prevalence after pustular diseases and, according to different data, they infect a third of the inhabitants of our planet. Feet Mycoses have been studied for more than a hundred years, but they have never managed to somehow come close to reducing infection, in recent years, on the contrary, the number of cases has only increased. This is easily explained by social factors and professions, where favorable conditions are created for the fungus (miners, military, metallurgists, etc.).

Varieties

The group of mycoses of the feet included diseases in which similar pathways of infection, symptoms, diagnosis and treatment. It is about the following ringworms:

  • Epidermofitiya. The causative agent of the fungus Trichophyton mentagrophytes var. Interdigitale, which is found in the scales and scraps of macerated epidermis. Epidermofitiya stop is very common in athletes (“athlete’s foot”), metallurgists, miners and the military. This is explained by the fact that the legs are constantly in closed shoes under the influence of elevated temperatures. From here strong perspiration of feet – the favorable sphere for reproduction of a fungus. Microtrauma, endocrine disruption, lack of personal hygiene and visits to public showers contribute to the spread. The initial stage is very easy to miss, as in most cases it has a scant clinical picture. There may be a slight peeling between the toes (most often in the fourth interdigital gap) and the appearance of small cracks on the heels. In advanced cases, there is a large number of bubbles on the sole and interdigital folds. Subjective feelings – itching and burning in the area of ​​the lesions. In 20-25% of patients there is also damage to the nail plates, which are deformed and crumble. Rarely localized lesions on the foot in the groin athlete, which is characterized by damage to the area of ​​the inguinal-femoral folds.
  • Rubrofitia. Rubromycosis is considered the most common mycosis of the feet, affecting the skin and nail plates on the feet. The causative agent of Trichophyton rubrum, which is characterized by a long stay in the stratum corneum without showing any clinical symptoms. Increased sweating, diseases of the endocrine system, a sharp decrease in immunity and body resistance are considered to be provoking factors for the activation of the fungus. The initial stage of foot rubromycosis is the appearance of mucous scales on the sole and enhancement of the skin pattern. Over time, lesions spread to the interdigital folds, toes and nails. Severe dryness of the skin on the heels and toes of the toes may be added to the initial symptoms. In the advanced forms, the nail plates are necessarily involved in the process, only in contrast to the athlete, which is almost always localized only on the I and V nail plates, ruberitis is characterized by the defeat of all the nails at once. At the initial stage, rubromycosis of nails is characterized by a change in the color of the nail plate and its slight deformation. The color may vary from pale yellow to brownish brown. In neglected forms, atrophy of the nail and its rejection from the bed is very often observed. And another important difference from athromophytosis of rubromycosis is the spread of the fungus from the feet and inguinal-femoral folds to the arms, face, back, abdomen and other areas of the body. Very often, different types of ruburitis are found among bath attendants, pool workers and people whose work is associated with high humidity and sweating.
  • Yeast Fungi. It is much less common than rubelitis or athlete. The causative agent is a fungus of the genus Candida, which is considered conditionally pathogenic and is present on the skin of each person. In 90% of cases, candidiasis affects the urogenital system, the skin of the inguinal-femoral folds and the perianal zone. But, there are also situations in which localization of foci is observed on the nail plates. A distinctive feature of candidiasis of the nails is severe itching and burning in the lesions themselves and near them. The initial process is characterized by the thinning of the nail plate and the change in its color (almost always tarnish). Spontaneous extinction of the process and abrupt renewal can also be observed – also a distinctive feature of all Candida lesions.

Also, some experts refer to the mycoses of the feet nail damage with mold fungi, which are not characterized by deep penetration deep into the skin, so they are treated much easier than the epidermis and rubromycosis. Characteristic differences are the appearance of black specks on the surface of the nail plate and a change in its color to green or yellow-brown.

Diagnosis and Treatment

Diagnosis of mycoses of the feet is based primarily on examination of the clinical picture and microscopic examination of scales, gun hair and nails from lesions. Very often, differential diagnosis of ruburitis with lichen planus or lupus erythematosus, and athlete with psoriasis and herpetiform Düring dermatitis are performed. For final confirmation of the diagnosis can be carried out culture.

Mycoses treatment is almost always divided into two stages:

  1. Preparatory. Elimination of inflammatory processes and removal of scales and other layers from the surface of the foot. Removal of horny layers and scales is carried out using keratolytic means. We are talking about compresses, which are made on the basis of vaseline, salicylic and lactic acid. Duration from 2 to 8 days, depending on the course of the disease and the nature of the lesions. Also shown are soda baths, after which the affected areas are carefully treated with pumice. For intertriginous and dyshidrotic forms of mycoses of the feet, the treatment is identical to the acute eczema.
  2. Main. Selection of antifungal drugs, depending on the type, location and prevalence of the fungus. There is no 100% correct regimen, but with erased and squamous forms, it is possible to do only with ointments, in cases with dyshidrotic form, complex therapy will be needed, including taking systemic antimycotic drugs and the use of external agents. Most often, in the treatment of mycoses of the feet, lamisil, clotrimazole, mikoseptina, micafungin and Castellani fluids are used. Moldy fungi are successfully treated with the use of the drug Orungal, and nail onychomycosis is treated with Griseofulvin in combination with local remedies. Very often, you have to remove the nail affected by the fungus and stick it with a keratolytic plaster. Two days later, the patch is removed and the bed is cleaned with a blade. Then, at the discretion of the doctor, an antimycotic agent is selected to treat the exposed bed.

It must be remembered that the treatment of mycoses of the feet is a long process, lasting in some cases for years. It implies not only the patient’s patience, but also the implementation of all the necessary therapeutic and preventive measures.

Photo of Mycosis of the Feet

Prevention and Prevention

Preventive measures of all types of foot mycoses should be aimed at creating the most unfavorable conditions for fungi. People who are overweight are shown to lose weight and thereby reduce the loads on their feet. If possible, avoid visiting public showers, baths and swimming pools (at least without your shoes). The owners of baths, swimming pools and public showers also have a number of requirements in the prevention of mycoses:

  • Replacing all wooden grilles with rubber mats;
  • individual rubber slippers for all employees and visitors;
  • chlorination of water in the pool and its frequent change;
  • disinfection of floors in baths, waiting rooms, showers, sports halls with the help of products containing bleach.

Great attention to the prevention of mycoses should also be given to the owners and employees of salons, where manicure and pedicure procedures are carried out. All instruments must be thoroughly disinfected after each client.

Well, the most commonplace, but often the stopping cause of a fungal infection, is a complete rejection of uncomfortable and closed shoes. Avoid excessive sweating (pour talc in socks), carry out shoe processing at least once every six months. Do not wear other people’s shoes, socks, pantyhose or stockings.

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