Fast Ringworm Cure
A 43-year-old man with type 2 diabetes of 2 years' duration was admitted via casualty with an infected neuropathic left foot with cellulitis, oedema and a purple patch on the dorsum of the foot. He was apyrexial. The dorsum of his foot was fluctuant and he was taken to theatre and underwent incision and drainage of an abscess. The pus from the abscess grew Staphylococcus aureus and he was treated with flucloxacillin 500 mg qds. The wound was not sutured but left open to heal by secondary intention. The original portal of entry was thought to be a webspace infected with tinea pedis. The foot healed in 9 weeks. He was issued with two pairs of bespoke trainer-style shoes and remained healed. Toe web infections with tinea pedis can be the portal of entry for deep soft tissue infections
Fungal infections develop as a result of poor foot hygiene, hyperhidrosis, and accumulation of moist detritus in the webs (Figure 8.6 shows another patient). Interdigital tinea pedis is the most common form of chronic fungal foot infection. itching, redness, scaling, erosion and soaking of the skin with fluid usually occur, while in the late phase the redness subsides. Trichophyton metagrophytes Trichophyton rubrum or Epidermophyton floccosum may be found. Keywords Web space infection fungus infection chronic tinea pedis Trichophyton metagrophytes Trichophyton rubrum or Epidermophyton floccosum.
In proximal subungual fungal infection, the second commonest form, Trichophyton rubrum accumulates hyperkeratotic debris under the nail plate and loosens the nail, eventually separating it from its bed. This fungus infects the underlying matrix and nail plate leaving the nail surface intact. Leuconychia mycotica, caused by Trichophyton metagrophytes, infects the nail superficially. The nail surface becomes dry, soft and friable but the nail remains attached to its bed. In addition to these fungi Epidermophyton floccosum may also be isolated from infected areas. Keywords Onychomycosis distal subun-gual onychomycosis proximal subungual fungal infection leuconychia mycotica Tri-chophyton metagrophytes, Trichophyton rubrum or Epidermophyton floccosum ter-binafine itraconazole fluconazole
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