Clinical characteristics of athlete’s foot and its combinations with dermatophytosis of other localizations

Background: Athlete’s foot (AF) is the most common fungal infection of the skin, characterized by various clinical manifestations. Dermatophytosis of other localizations can result from autoinoculation from a source on the feet. The relationship between the clinical forms of mycotic lesions of the feet and the spread of the pathological process to other areas of the skin has not been sufficiently studied.

Objective: Evaluation of the clinical forms of AF and their combinations with dermatophytosis in other locations.

Materials and methods: The study included 125 patients with AF aged 20–86 years, including 57 (45.6%) men and 68 (54.4%) women. The patients were divided into 2 groups: group 1 – 40 people with a combination of dermatophytosis of the feet and dermatophytosis of the skin beyond them, group 2 – 85 patients with dermatophytosis of the feet without changes in other areas of the skin. All patients underwent registration of anamnesis data and a clinical examination with photo fixation after signing informed consent. In order to detect fungal mycelium, direct microscopic examination with 10% NaOH was performed from the lesions, including the nail plates when they changed. The clinical form of AF was assessed based on visual examination.

Results: There were no significant differences in the distribution of patients in the two groups by age (p=0.95) and gender (p=0.955). Among patients in Group 1, the squamous form of AF was detected in 60% of cases (p=0.007), the disease duration was over 5 years in 85% (p=0.048), and onychomycosis of the toes was found in 95% (p<0.05). The most common foci of dermatophytosis were localized in the groin area (37.5%), on the smooth skin of the shins (20%) and trunk (20%).

Conclusion: The spread of fungal infection beyond the feet occurs in patients with the most clinically unexpressed (squamous) form of the disease, does not depend on the patient’s gender and is combined with damage to the nail plates, with frequent involvement of the skin of the inguinal folds.