Tenia Pedis - TINEA OF FEET AND HANDS

Tenia Pedis is very common in tropical and subtropical countries; common in the summer and the monsoon than in the winter. Men are more frequently affected than women. The incidence is directly related to the spread of civilization (Western). Heavy, closed and ill-fitting shoes worn for long hours predispose the individual to infection.

Lesions may appear as isolated vesiculo-pustules, or bullae, or as patches of erythema and oedema with a scattering of vesicles and pustules, the vesicles may develop into ulcers. Oozing is slight. It is accompanied by intense itching and burning. Secondary infection results in pain, lymphangitis and regional lymphadenitis. This variety has the appearance of an eczematoid or pompholyx eruption. Auto- sensitization produces an ide eruption (which resembles dyshidrosis from which it must be differentiated) on the palms of hands, and, may be, the, other parts of the body as well.

In the chronic: hyperkeratotic variety, well-defined patches of hyperkeratotic, powdery scaling on erythematous-thickened bases are seen on the soles and sides of the feet and the palms of the hands. This condition is asymptomatic except for an annoying roughness.

Diagnosis of Tenia Pedis

If the, characteristics described above are borne in mind the diagnosis of tinea of the hands and the feet are not difficult. It should always be confirmed by a microscopic demonstration of the fungus.

Prognosis of Tenia Pedis

The outlook as to complete cure is fair if the disease is treated by an expert, and the patient is co-operative.

Treatment of Tenia Pedis

The acute stage must be treated like acute eczemas with potassium permanganate soaks and silver nitrate or gentian violet paint. Only when the acute inflammation has subsided should active fungicidal agents be gradually introduced on the lines recommended in the treatment of tinea corporis. Tinactin (P), econazole lotion or cream and Whitfield's ointment are effective in the hyperkeratotic variety. Castellani's paint or tincture Merthiolate (P) is often employed to treat the chronic interdigital variety. Paints containing spirit tend to harden the skin. It is better to use the paint in the morning and a fungicidal ointment like Vioform (P), Sagatrun (P), in the night. The best results have been reported with tolnaftate/econazole.

Shoes and socks must be sterilized; the former, with formalin vapours by putting cupful of commercial formaldehyde in a closed box containing the shoes, for 48 hours. The shoes must be exposed to the mild sun and fresh air for at least two days before being worn, so that the feet are not irritated by the formalin. Socks are sterilized by boiling.