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If the above diagnoses are inconclusive or if a treatment regimen has already been started, a biopsy of the affected skin (i.e.
Spray tub and bathroom floor with disinfectant after each use to help prevent reinfection and infection of other household members.
Wash feet, particularly between the toes, with soap and dry thoroughly after bathing or showering. If you have experienced an infection previously, you may want to treat your feet and shoes with over-the-counter drugs. Dry feet well after showering, paying particular attention to the web space between the toes. Try to limit the amount that your feet sweat by wearing open-toed shoes or well-ventilated shoes, such as lightweight mesh running shoes. After any physical activity shower with a soap that has both an antibacterial and anti-fungal agent in it. This website is dedicated to the development and dissemination of medical information that may be useful to those who practice Operational Medicine. Athlete's foot refers to moist peeling irritable skin between the toes, most often in the cleft between the fourth and fifth toes.
Tinea pedis is more common in adults than in children and frequently recurs after initially successful treatment with topical antifungal agents because of reinfection. First confirm the diagnosis of tinea (scrapings and clippings) and look for other sites of infection (groin, nails). Mild and localised tinea pedis can be managed with education and topical antifungal agents. There are numerous topical antifungal agents, of which terbinafine cream (Lamisil™) is probably the most effective.

Whitfield's ointment is also effective (benzoic acid 6%, salicyclic acid 3% in emulsifying ointment).
Resistant and extensive culture-confirmed cases of tinea pedis will require oral therapy for one to four weeks, usually with terbinafine or itraconazole (the latter requires specialist approval for PHARMAC subsidy). Confirmed tinea unguium may require oral antifungal agents for 3 months or longer if the infection is clinically significant and there are no contraindications to treatment. In a busy dermatology office, it would not be unusual to see three to six patients a day with some form of dermatophyte infection. Marcus is a 19-year-old white man who presented to the clinic with a 3-month history of a red rash in the groin area. A potassium hydroxide (KOH) wet mount examination of scale taken from the advancing border of the lesion revealed tubular, branching, hyphae characteristic of TC fungal infection. Dermatophytes produce enzymes - keratinases that break down keratin and result in fungal invasion of the cornified layer of the epidermis.4 The differential diagnosis list for TC should include intertrigo, erythrasma, psoriasis and allergic or irritant contact dermatitis. Put socks on before underwear to avoid spreading fungal infection from athlete's foot or nail fungus. Fungal spores can persist for months or years in bathrooms, changing rooms and around swimming pools. Tell the patient to hot wash socks and stockings, and to wipe out shoes with formalin or meths solution.
Cure rates depend on the severity of infection, the infecting organism, comorbidities and the age of the patient. In fact, the prevalence of dermatophyte infections in the United States is estimated at 20%.1,2 Men are three times more likely than women to experience tinea cruris (TC), and it is also more common in adults. He is a member of his college fencing team and practices 2 to 3 hours a day, 4 to 5 times a week.

However, KOH results may be negative in patients who have sporadically or incompletely used topical antifungal preparations.4,5 One approach to a negative KOH wet mount and a high suspicion of TC is to have the patient stop any treatments to the area for a week and repeat the KOH wet mount. TC, the second most common clinical presentation for dermatophytoses, is a superficial fungal infection of the groin and adjacent skin. Dermatophytes are usually spread by person-to-person contact (anthropophilic), but they may also infect through contact with contaminated soil (geophilic), animals (zoophilic) or by fomites (linen, towels, clothing, upholstery).4,5 Dermatophyte infection by self-inoculation is particularly common in TC when tinea unguium or tinea pedis is also present. They should be advised that the condition is mildly contagious, and to wear sandals in changing rooms and not to share towels and footwear.
However, with the increase in childhood obesity and diabetes, the incidence of TC is increasing in the pediatric population.1-3 This article presents a case study of a young adult seen in clinic for TC. He sometimes showers at the gym after practice, but he also delays taking a shower for a few hours until he gets back to his dormitory. It is likely to recur, so suggest they dry carefully and apply an antifungal powder after bathing long term.
Marcus used a family member's steroid cream for a few days, which seemed to improve the rash and stop the itching.
There were no secondary skin changes, including lichenification, excoriation or impetiginization.

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