Author: Houmin Li (Peking University People’s Hospital)
Athlete’s foot, commonly known as “beriberi”, is a superficial fungal disease caused by dermatophyte infection. It is one of the most common skin diseases, with an incidence of as high as 25% in the population. % is known to us.
However, are all skin diseases on the feet “beriberi”? Of all the skin diseases that occur on the feet, some are not athlete’s foot, although they look similar to the rash of athlete’s foot. Below is a brief summary.
First, the disease that needs to be differentiated from vesicular tinea pedis
Sweat herpes is an endogenous skin eczema-like reaction that may be related to contact stimulation, nervous system dysfunction, and mental factors (such as mental stress, depression, etc.).
Young and middle-aged adults are vulnerable to this disease. It generally begins to appear at the turn of spring and summer, worsens in summer, disappears slowly in winter, and repeats this process in the coming year.
Sweat herpes often grow symmetrically on the palms, sides and tips of the fingers, but generally do not appear on the backs of the hands and feet. The blisters of sweat herpes may be one or more than a dozen, round, deep, and can be felt by hand.
Image source: Zhanku Hailuo
The skin around the blisters is normal. The blisters are transparent and shiny, and are not easy to break. After 2 to 3 weeks, the “water” in the blisters is absorbed, and the blisters dry and peel.
Sweat herpes is often accompanied by itching, tingling, and burning.
1. Palmoplantar pustulosis
The cause of palmoplantar pustulosis is unknown, but it is thought to be a specific type of psoriasis (commonly known as “psoriasis”).
The causes of the disease include various external stimuli (soaps, detergents and topical stimulant drugs), sweaty palms and soles of the feet in summer, premenstrual period, smoking and other factors.
Middle-aged women have a higher incidence than other populations. The rash of the disease is manifested as pustules that first appear on the inner and outer sides of the palms and the soles of the soles of the feet, and gradually spread to the entire palms and soles, as well as the flexors of the fingers and toes, and often appear symmetrically on the left and right sides. Fungal infection rash of the toe) seams and nails.
The typical course of the disease is that on the reddened skin, pinpoint-sized blisters appear, the blisters continue to grow, and a small yellow spot appears in the center, which expands outward. Within hours, the blisters turn into pustules, about the size of a grain of rice to a mung bean, and after 2 days to 2 weeks, the pustules dry out, crust over, and then fall off.
The pustules can also appear on normal skin at first, but the surrounding skin immediately becomes red and peeled. The erythema can continue to expand and merge into large erythema, or it can be covered by normal skin piece by piece. separated.
Patients with palmoplantar pustulosis often experience itching, sometimes burning, dryness, and pain in the area of the rash.
Image source: Zhanku Hailuo
This disease often grows better and longer, and recurring for a long time can cause rough, thickening, scaling, and cracking of the hands and feet.
Second, the disease that needs to be differentiated from macerating and erosive tinea pedis candida intertrigo
Candidal rubella is caused by Candida (a fungus) infection of the localized skin. It is more common in infants and young children, people with diabetes, and people whose skin between the fingers is always excessively moist. Such as obese and sweaty people, domestic workers and special occupations who have long-term exposure to water.
This disease is most common between the fingers (toes), but can also occur in areas where the skin folds are not ventilated, such as the perineum, the base of the thighs, the armpits, and under the breasts in women. When it occurs in the suture of the fingers (toes), it is more common between the 3rd and 4th (toes).
Its rash is a well-defined erythema, with whitish and eroded surface, scattered rice-grain-sized rashes around the erythema, small blisters or pustules may be found above some of the rashes, and often accompanied by peeling.
Occurs between the fingers (toes), and the skin around the fingers (toes) often becomes thick and white due to moisture, and it is easy to peel off. The skin exposed after peeling off this layer of horny It is bright red and smooth and moist.
Patients with candidal rubella are generally asymptomatic, with occasional itching or pain.
Candidal rubbing rash that occurs between the fingers (toes) is very similar to macerating erosive athlete’s foot. If it cannot be distinguished by clinical manifestations, you can go to the hospital, and the doctor will perform a direct microscopic examination of the fungus. and cultivation, it can be distinguished.
Image source: Zhanku Hailuo
Dr. Yuan Yunyan, Peking University People’s Hospital contributed to the writing of this article
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