Athlete's foot physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2] Sanjana Nethagani, M.B.B.S.[3]

Interdigital tinea pedis

Most common type of athlete's foot is interdigital tinea pedis infection.
It is characterised by maceration, scaling, peeling of skin.^[1]
Secondary bacterial infections are common.

Vesicolobullous tinea pedis

Bullae or tense vesicles are seen over the anterior plantar surface.
Pain is often an accompanying symptom.
Vesicles appear in a symmetric fashion and may mimic pompholyx (dyshidrosis).
Dermatophytid reactions or identity reactions are most commonly seen in this type.
Secondary bacterial infections of ruptured bullae/vesicles may lead to ulcerative tinea pedis.

Chronic hyperkeratotic tinea pedis

Diffuse hyperkeratosis is the defining feature of chronic infection.^[2]
Skin is erythematous and has silvery scales.
Moccasin like distribution over the feet is seen, thus chronic intertriginous tinea is also called "moccasin" tinea pedis.

Ulcerative tinea pedis

This type is usually seen in diabetic patients.
It is characterised by ulcers, vesicles, pustules which begin in the interdigital web spaces which spread rapidly and may lead to a secondary bacterial infection.
Cellulitis, lymphangitis, edema are commonly seen with this type.