Athlete's Foot: Insights from a Dermatology Consultation

Q: Athlete's Foot: Insights from a Dermatology Consultation

Hello： I believe it would be better to see photos for clearer communication. <br>If there is usually peeling without itching, it is more likely to be "tinea pedis" (athlete's foot). <br>If there is the presence of fluid and it is very itchy followed by peeling, this is indicative

Hello doctor, I have a question regarding athlete's foot..?

Hello Dr.
Chang, this is the student Zhang who previously had athlete's foot issues.

1.
Today I visited the dermatology department at Kaohsiung Medical University Hospital.
However, due to wearing sneakers, my feet were sweaty and the doctor couldn't see the areas with fissures.
The doctor who examined me was an attentive physician named Dr.
Chang Rui-Chao.
Since he couldn't see the fissures and peeling areas (although the doctor at the clinic I visited before used a flashlight), he diagnosed me with "contact dermatitis" and prescribed two tubes of "betamethasone dipropionate" (also known as "Suhfu Tong").
However, it was out-of-pocket because the doctor said it would be cheaper that way.
2.
I was wondering if I could take photos of the areas when the fissures are more apparent and show them to you.
Would that provide a more accurate assessment? I mean no offense; it's just that I've seen four different doctors, and their diagnoses have varied (which is quite frustrating).
Having you, Dr.
Chang, take a look might be more helpful.
With the current health insurance situation, a visit to the dermatology department costs 3,400 NTD! I've spent all my allowance on medical visits this month.
Additionally, the area in front of my nail folds is itchy! Also, my palms have been peeling and developing fissures, but sometimes it's on my left hand and sometimes on my right.
Thank you for your assistance, Dr.
Chang!

Zhang Tongxue, 20~29 year old female. Ask Date: 2008/08/01

Dr. Zhang Zhibo reply Dermatology

Hello: I believe it would be better to see photos for clearer communication.
If there is usually peeling without itching, it is more likely to be "tinea pedis" (athlete's foot).
If there is the presence of fluid and it is very itchy followed by peeling, this is indicative of "miliaria" (heat rash).
The cause may be due to tinea pedis, and treating the athlete's foot can help control the production of fluid.
Septon ointment is used for the treatment of "miliaria." If there is no improvement after 1-2 weeks, a follow-up visit is necessary to reassess and change the medication.
If there is some improvement but frequent recurrences occur, a short-term treatment with oral corticosteroids combined with topical antifungal ointments can be considered.

Reply Date: 2008/08/01

More Info

Athlete's foot, or tinea pedis, is a common fungal infection that primarily affects the skin on the feet. It is often characterized by itching, burning, and peeling skin, particularly between the toes and on the soles of the feet. The condition can be exacerbated by factors such as excessive sweating, tight footwear, and poor foot hygiene, which can create an environment conducive to fungal growth.

From your description, it seems that you have been experiencing symptoms that could be indicative of athlete's foot, particularly the peeling and itching. The fact that you have seen multiple doctors and received different diagnoses can be frustrating, but it is not uncommon in dermatology, as skin conditions can sometimes present similarly.

The dermatologist you consulted, Dr. Zhang Ruichao, diagnosed you with contact dermatitis, which is an inflammation of the skin caused by contact with an irritant or allergen. This diagnosis may have been made due to the lack of visible lesions at the time of your visit, especially if your feet were sweaty and the skin was not easily examined. The prescription of betamethasone dipropionate, a topical corticosteroid, is typically used to reduce inflammation and alleviate itching, which may help if your condition is indeed inflammatory in nature.

Taking photographs of your feet when the symptoms are more pronounced is an excellent idea. This can provide valuable information to your healthcare provider and may assist in making a more accurate diagnosis. It is essential to document any changes in your symptoms, including the appearance of the skin, the presence of blisters, or any other notable features.

In addition to the topical treatment you are using, there are several other strategies you can implement to manage and prevent athlete's foot:
1. Keep Your Feet Dry: Fungi thrive in moist environments, so it is crucial to keep your feet dry. Change out of sweaty socks and shoes as soon as possible, and consider using moisture-wicking socks.

2. Choose Breathable Footwear: Opt for shoes made from breathable materials that allow air circulation. Avoid tight-fitting shoes that can trap moisture.

3. Use Antifungal Powder: Over-the-counter antifungal powders can help keep your feet dry and reduce the risk of fungal growth.

4. Practice Good Hygiene: Wash your feet daily with soap and water, and dry them thoroughly, especially between the toes.
5. Avoid Walking Barefoot in Public Areas: Fungi can be present in communal areas such as swimming pools, locker rooms, and showers. Wearing flip-flops or water shoes in these environments can help protect your feet.

6. Consider Oral Antifungal Medications: If topical treatments are ineffective, your doctor may recommend oral antifungal medications, especially if the infection is widespread or recurrent.

7. Monitor Your Symptoms: If your symptoms persist or worsen despite treatment, it is essential to follow up with your healthcare provider. They may consider additional diagnostic tests, such as a skin scraping or culture, to confirm the presence of a fungal infection.

In summary, while your current diagnosis may be contact dermatitis, the symptoms you describe are consistent with athlete's foot. Keeping a record of your symptoms and following up with your healthcare provider is crucial for effective management. Implementing preventive measures and maintaining good foot hygiene can significantly reduce the risk of recurrence. If you continue to experience issues, consider seeking a second opinion or consulting a dermatologist who specializes in fungal infections.

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