Dermatology   [back to the Category]

Interdigital intertrigo of the toes (athlete's foot)   [read the french version]

Author :   Dr Michel Canesi.

Interdigital intertrigo of the toes (athlete's foot)

This complaint often starts in the 4th interdigital space.

It is caused by a dermatophyte which is often linked to bacteria, yeasts, moulds.

There are two clinical types:

- inflammatory: this is a macerated, pruriginous intertrigo, the base of the space between the toes appears whitish with thick, damp squamae;

- fissural: the injuries are keratosic and painful. There is a sensation of burning and fissures appear at the base of the skin fold.
Evolution can lead to the nails becoming affected( fig1 & fig2), a superinfection affecting the dorsum of the foot, lymphangitis, adenopathies, temperature, even, plantar dyshidrosis.

Treatment varies with the type.

If it is inflammatory: rest, foot baths with foaming antiseptic solutions such as "Plurexid", "Cyteal", etc., alcohol colouring agents, antiseptics, followed by fungicidal applications. Antibiotics are only necessary in the case of superinfection.

For the dry type: remove the hyperkeratosis (urea preparations or "Xerial 50") and apply fungicides locally. In both cases, a short course of griseofulvin by the mouth, or, nowadays rather, terbinafine, is often necessary especially if the problem is caused by Trichophyton rubrum. Fungicides such as "Fazol", "Pevaryl", "Amycor", etc. are often used locally.

Prevention consists in washing your feet after every practise session and every performance, in drying them carefully, especially between the toes, in avoiding narrow, warm, damp boots and shoes, in preferring open shoes such as sandals, and, in regularly changing your stockings and socks which should preferably be cotton. We strongly recommend that you put antimycotic powder in your ballet shoes.

Bibliography:

Brun D - La pathologie dermatologique du sportif. Thèse, Nancy, 1995; p 19-41.

Cohen BA - Les pieds de l'athlète. Cutis 1977; 1 : 139-144.

B Daum*, A Barbaud **, JL Schmutz**
*CHU Brabois, 54500 Vandoeuvre-lès-Nancy ** CHU, Hôpital Fournier, Nancy Cedex BEDC January 1999.