Athlete's foot

　　Tinea pedis is a skin disease of the foot caused by pathogenic fungi, which is highly contagious. Tinea pedis is widely prevalent worldwide, more common in tropical and subtropical regions. In China, the incidence of tinea pedis is also quite high. The soles of the feet and between the toes lack sebaceous glands, thus lacking fatty acids to inhibit skin filamentous fungi, and have poor physiological defense mechanisms. However, the skin in these areas has abundant sweat glands, producing more sweat. The poor ventilation, local humidity, and warmth are conducive to the growth of filamentous fungi. In addition, the skin on the sole is thicker, and the keratin in the stratum corneum is a rich nutrient for fungi, which is conducive to the growth of fungi.

　　During pregnancy, women are prone to tinea pedis due to changes in endocrine function, which reduces the skin's ability to resist fungal infections. Obese individuals are prone to tinea pedis due to moisture between the toes and sweat soaking. Trauma to the foot skin, which damages the skin's defensive function, is also one of the factors that trigger tinea pedis. Diabetics are prone to tinea pedis due to insulin deficiency leading to metabolic disorder, increased sugar content in the skin, and reduced resistance. The use of antibiotics, long-term use of corticosteroids, and immunosuppressants can also disrupt the normal flora of the skin, increasing the susceptibility to tinea pedis.

　　The occurrence of tinea pedis is also related to lifestyle. Some people do not pay attention to the cleanliness and hygiene of their feet and shoes, providing a good breeding ground for fungi.

　　Tinea pedis may also be accompanied by skin fungal infections in other parts of the body. Due to long-term tinea pedis or autoinoculation after scratching with hands, patients with tinea pedis may also have onychomycosis, tinea manuum, and tinea cruris, among others. When onychomycosis occurs, the nail plate becomes turbid, opaque, showing a cloudy or stained appearance, and the surface loses its luster.

　　Patients with tinea pedis are also prone to bacterial infections. At this time, local secretions increase, and pale yellow purulent secretions may appear. The infected area is red, swollen, hot, and painful. If timely and appropriate anti-inflammatory treatment is not provided, it may lead to lymphangitis, erysipelas, and cellulitis, among other conditions.

　　(1) Lymphangitis

　　Commonly known as 'red line', in traditional Chinese medicine it is called 'red line rash', which is an acute inflammation caused by pyogenic bacteria entering the lymphatic vessels from broken skin.

　　(2) Erysipelas

　　Erysipelas is a relatively serious acute inflammatory disease. Erysipelas in the lower leg is also known as 'running fire'. It is an acute inflammation of the lymphatic vessels and surrounding soft tissue in the skin and subcutaneous tissue, caused by Streptococcus hemolyticus entering medium or small lymphatic vessels through damaged skin.

　　(3) Cellulitis

　　In traditional Chinese medicine, it is called 'bi jiu', which is generally caused by secondary streptococcal infection. It can also refer to acute diffuse suppurative inflammation of loose connective tissue caused by Staphylococcus, Escherichia coli, and other bacteria. This lesion can occur in relatively shallow skin areas, as well as in deeper areas such as beneath the fascia or between muscles.

　　The clinical manifestations of tinea pedis include vesicles, desquamation, or whitish, soft skin between the toes, which can also appear as erosion or thickening, roughness, and cracking of the skin, which can spread to the sole and edge of the foot, with severe itching.

　　1. The rash occurs on the sole, edge, arch, and interdigital and flexural sides of the foot.

　　2. It often occurs or worsens in the summer and improves in winter.

　　3. The morphology of skin rash is divided into three types: vesicular type, ulcerative type, and scale type. Different types can transform into each other, or exist simultaneously. However, one type is often predominant at a certain period.

　　⑴ Vesicular type: Commonly occurs on the arch and sides of the toes. The manifestations are clusters or scattered deep small vesicles, like millet in size, with thick vesicle walls. After bursting or absorption, there are a few scales. There is significant itching, often leading to secondary infection due to scratching or picking vesicles with a needle.

　　⑵ Ulcerative type: Occurs between the toes, especially between the third and fourth toes. The manifestations are local epidermal moisture, maceration, and whitening, with severe itching. It often causes the epidermis to break and peel off due to scratching and friction, exposing a red ulcerous surface, at which time there is itching and burning pain, and the secretion has a special odor. This type is also prone to secondary infection due to scratching.

　　⑶ Scale-type: Occurs on the sole and edge of the foot. The manifestations are hyperkeratosis, dryness, roughness, desquamation, and pale red base. There is slight or no itching. In winter, it can cause fissures and pain.

　　4. The course is slow, usually not cured for many years.

　　5. Direct microscopic examination of fungi or fungal culture can be performed to further clarify the diagnosis.

　　Tinea pedis is most prone to occur in dark, warm, and humid environments. Therefore, be cautious of places with poor disinfection, such as public changing rooms, and change shoes and socks frequently, and wear breathable shoes, which are all beneficial to prevent tinea pedis.

　　1. Pay attention to cleanliness, keep the skin dry, keep the feet clean, wash them several times a day, and change socks frequently.

　　2. Use separate foot basins and towels for drying feet to prevent transmission to others.

　　3. It is not advisable to wear non-ventilated shoes such as sports shoes and travel shoes, as this may cause excessive foot sweat and intensified foot odor. People with tight toe spaces can use clean gauze or cotton balls between their toes or choose toe separators to facilitate water absorption and ventilation.

　　4. Avoid eating foods that are prone to induce sweating, such as chili, scallions, and garlic.

　　5. Maintain a tranquil mood; excitement and excitement are prone to induce excessive sweating and exacerbate tinea pedis.

　　6. Tinea pedis is a contagious skin disease and should be avoided from scratching to prevent self-infection and secondary infection.

　　The examination of tinea pedis requires the collection of fresh vesicle walls or deep skin scales for fungal microscopy, which can reveal hyphae and spores. The diagnosis is generally not difficult based on clinical manifestations and mycological examination. Fungal tests can be repeated if necessary. It should be distinguished from interdigital pyoderma, dyshidrosis, and eczema.

　　Tinea pedis patients should first eat a variety of foods rich in vitamin B1 to supplement a large amount of thiamine. Adults generally need about 1.5 milligrams per day, including various coarse grains, cereals, peanuts, soybeans, brown rice, etc. It is appropriate to eat high-protein foods, 1.5 grams per kilogram of body weight per day, and various animal foods can be selected, such as eggs, milk, fish, and soy products.

　　1, Starch and bean selection: Unrefined wheat flour, soybean powder, millet, corn, rice, etc.

　　2, Meat, egg, and milk selection: Lean pork, pork liver, chicken liver, eggs, etc.

　　3, Vegetable selection: Radishes, eggplants, cabbage, winter melon, etc.

　　4, Fruit selection: Apples, pears, grapes, etc.

　　5, Other: Sunflower seeds, peanuts, cashews, almonds, etc.

　　The general treatment for tinea pedis in Western medicine usually uses antifungal drugs such as econazole, itraconazole, terbinafine, etc.; during treatment, the "1+1" therapy (such as applying and taking binafine orally for one week) is often adopted. Local keratolytic agents such as salicylic acid can also be selected.

　　Tinea pedis should be treated early. Tinea pedis not only affects daily life but can also trigger serious diseases such as erysipelas.

　　Choose the correct medication for treating tinea pedis. Tinea pedis is caused by fungi, and antifungal drugs should be used. Topical hydrocortisone, Derma-Pan ointment, and other drugs may have the opposite effect and help the spread of tinea pedis.

　　Do not discontinue medication on your own. Do not use the relief of itching as a standard for cure, but use the drug until the fungus is killed.

　　During the treatment period, the socks, underwear, and bedding taken off by the patient should be boiled with hot water (above 60℃) to reduce the possibility of transmission.

　　When tinea pedis has secondary infection, local acute inflammation may occur. It cannot be treated as general tinea pedis. Secondary infection should be treated first. If there is redness and swelling, local application of borax water or furazolidone solution for cold and warm compress can reduce inflammation and swelling. In necessary cases, systemic antibiotics should be administered, and appropriate rest should be taken according to the doctor's instructions.