Tinea Types: Common Dermatophyte Infections Tinea Pedis and Onychomycosis

June 1, 2004
Joe Monroe, PA-C
Joe Monroe, PA-C

A 50-year-old man had a long-standing rash on both soles. The patient’s toenails were yellow and dystrophic. These physical findings strongly suggested moccasin-variety tinea pedis and onychomycosis.

A 50-year-old man had a long-standing rash on both soles. The patient's toenailswere yellow and dystrophic. These physical findings strongly suggested moccasin-variety tinea pedis and onychomycosis (also called tinea unguium)--twooften concurrent infections. A potassium hydroxide examination confirmed thesuspected diagnoses.Moccasin-variety tinea pedis is virtually impossible to cure; however, it canbe controlled with topical antifungals.Onychomycosis can be treated with oral terbinafine, 250 mg bid, for thefirst 7 days of 4 consecutive months. This infection is potentially curable butdifficult to treat, because therapy is expensive, associated with rare but potentiallydangerous side effects, and ineffective in at least 35% of patients.1 In addition,most older patients with onychomycosis are susceptible to the infection,as they are to tinea pedis. Even with adequate treatment, reexposure is inevitablebecause the organism is ubiquitous in the environment.