Probably one of the most missed diagnosis of the foot I see is Chronic Dermatophytosis, aka Athlete’s Foot. We all seem to recognize the acute form many get in high school where the feet itch excessively and the skin between the toes is wet and has turned white, aka maceration, but we often mistake the chronic type of dermatophytosis as dry skin. Patients say, “Doc I keep putting moisturizing cream on my skin but they still look dry”. Well that’s because their problem is a fungus, not dry skin.
You do not have to be a member of a sports team to get athlete’s foot. In fact, believe it or not, you don’t even have to play a sport. The condition itself usually results from an overgrowth of a particular fungus organism. In most cases, the areas between the toes and the arch of the foot are most often involved. Athlete’s foot may appear in different stages, each with its own presentation. For instance, the acute stage may have blisters or have intense itching. In addition, there may be maceration between the toes and occasional drainage. The chronic condition is characterized more by a dry and scaly appearance and rarely itches. My favorite description of chronic dermatophytosis (yes I have a favorite!) is “a moccasin distribution of dry ruptured vesicles”. There is some confusion as to how this skin condition can be transmitted but at the present time, the consensus of opinion is that there is a contagious capacity. In short, you might be able to catch it from the next guy or gal, so watch your barefoot walking! Also, it can come from fungal toenails if you have those.
Occasionally, an athlete’s foot condition will become infected and require more extensive therapy. In actuality, the threat of subsequent infection is probably a prime reason for treating more aggressively the earlier stage of the condition. After all, one might ask, what is really so bad about a little itching between the toes. Well, by itself, probably not a whole lot. But in those cases where that little itching develops into a more involved complication, then we might be facing a more serious problem.
At the first sign of an athlete’s foot condition, I would recommend a short trial period of a medicinal preparation available at the pharmacy in spray or cream varieties. Following several days use, if the condition persists, I would recommend a visit to the foot specialist. One thing is for sure, do not give up your athletic status in the hopes of relinquishing your athlete’s foot!