Moccasin-variety Tinea Pedis
70 M chronic scaly feet. Over the years: rash has itched only occasionally; however, post recent hot weather: it became highly pruritic & hydrocortisone ointment worsen it. Diagnosis?
Moccasin-variety tineapedis - 3 groups of dermatophytes cause tinea pedis: Trychophyton sp, Epidermophyton sp & Microsporum sp. pruritic, erythematous, scaly eruption on foot & depending on its location: 3 variants: interdigital, moccasin & vesiculobullous type
Moccasin type tinea pedis is more severe, prolonged form that covers bottom & lateral aspects of foot. Its appearance is that of a slipper or moccasin covering the foot, hence the name. T. rubrum is most commonly associated culprit.
Moccasin tinea pedis skin of inflamed area is often scaly & hyperkeratotic w/ erythema around soles & sides of foot. Papules may also be noted around demarcation line of erythema that surrounds foot. Either foot may be affected, however bilateral involvement is most often seen
DDX: psoriasis; dyshidrotic, atopic, or allergic eczematous dermatitis; pitted keratolysis; and various keratodermas
Topical anti fungal can be used but may fail requiring oral antifungal therapy with terbinafine, itraconazole, or fluconazole.
- Indiana University Infectious Diseases Fellowship @IUIDfellowship
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