Tinea Pedis Complex

A 38-year-old man noted a gradually increasing, initially itchy and then painful, rash on the feet.

Key point: In this case, the interdigital skin is not just macerated, but superficially ulcerated (eroded). This is tinea pedis complex, and may involve elements of dermatophytosis, bacterial superinfection, and irritant or allergic contact dermatitis related to self-medication.

Treatment: This multi-factorial eruption requires topical or systemic antifungal treatment in conjunction with broad-spectrum antibacterial therapy, topical desiccating maneuvers (such as Burrow’s soaks), and discontinuation of OTC interventions that might be worsening the problem.

Note: Keeping the toes separated with cotton dental logs may hasten the resolution of this difficult to manage disorder.