Tinea pedis in Child
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Synopsis
Tinea pedis ("athlete's foot") is a localized superficial fungal infection. It is rare in childhood and occurs more commonly in adolescents. The infection causes dry scale on the feet, maceration between the toes, and, in some cases, destruction of the nail plate (onychomycosis). Factors leading to this infection include high levels of humidity; occlusive footwear; and the use of communal pools, showers, or baths (including locker rooms).
The clinical presentation of tinea pedis may vary. The web spaces and soles are affected most frequently, but the condition may spread to involve the nonplantar surfaces of the foot as well. Interdigital maceration, especially of the lateral toe webs, is commonly seen. Tinea pedis is frequently asymmetric with one foot only being affected or disease being more widespread on one foot than the other. The degree of associated pruritus varies, but most cases are asymptomatic. Trichophyton rubrum may present with a red, scaly, moccasin-like plaque involving the sole. The bullous form of tinea pedis is rare in children and is usually caused by Trichophyton interdigitale (formerly T mentagrophytes var interdigitale). Onychomycosis may be associated.
Interdigital cracking and maceration may act as a portal of entry for pathogens and may predispose to lymphangitis or cellulitis. A dermatophytid reaction (also called an "id reaction") is a hypersensitivity process that can occur secondary to tinea pedis. The condition manifests on the lateral aspects of the fingers and may mimic dyshidrotic dermatitis. This hypersensitivity process will resolve with adequate treatment of the dermatophyte infection.
Immunocompromised patient considerations: In patients with human immunodeficiency virus (HIV) infection and other T-cell disorders, interdigital tinea pedis has been noted to spread to involve the dorsal foot in an extensive manner.
The clinical presentation of tinea pedis may vary. The web spaces and soles are affected most frequently, but the condition may spread to involve the nonplantar surfaces of the foot as well. Interdigital maceration, especially of the lateral toe webs, is commonly seen. Tinea pedis is frequently asymmetric with one foot only being affected or disease being more widespread on one foot than the other. The degree of associated pruritus varies, but most cases are asymptomatic. Trichophyton rubrum may present with a red, scaly, moccasin-like plaque involving the sole. The bullous form of tinea pedis is rare in children and is usually caused by Trichophyton interdigitale (formerly T mentagrophytes var interdigitale). Onychomycosis may be associated.
Interdigital cracking and maceration may act as a portal of entry for pathogens and may predispose to lymphangitis or cellulitis. A dermatophytid reaction (also called an "id reaction") is a hypersensitivity process that can occur secondary to tinea pedis. The condition manifests on the lateral aspects of the fingers and may mimic dyshidrotic dermatitis. This hypersensitivity process will resolve with adequate treatment of the dermatophyte infection.
Immunocompromised patient considerations: In patients with human immunodeficiency virus (HIV) infection and other T-cell disorders, interdigital tinea pedis has been noted to spread to involve the dorsal foot in an extensive manner.
Codes
ICD10CM:
B35.3 – Tinea pedis
SNOMEDCT:
6020002 – Tinea pedis
B35.3 – Tinea pedis
SNOMEDCT:
6020002 – Tinea pedis
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Last Reviewed:08/15/2019
Last Updated:12/09/2020
Last Updated:12/09/2020
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Tinea pedis in Child
See also in: Cellulitis DDx