Candidosis, interdigital B37.2

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

blastomycetica interdigital erosion; Erosio interdigitalis candidamycetica; interdigital candidiasis; Interdigital candidiasis; Interdigital Candidosis

History
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Gougerot and Goncea 1915; Fabry J 1917

Definition
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Special form of intertriginous candidosis in the interdigital spaces.

Etiopathogenesis
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Hyperhidrosis, occlusive footwear and poor foot hygiene have a promoting effect. If the interdigital spaces are affected, damp work or flour work must be taken into account. Wearing rings also has a positive effect.

In addition to Candida albicans, Candida guilliermondii and others have been identified as causes of interdigital candidiasis.

Localization
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Especially on the feet, in the toe spaces of the 2nd - 4th digitus. It is not uncommon for the interdigital spaces 3 and/or 4 to be affected (Schlager E et al. 2018).

Clinical features
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Striking is the strong maceration of the horny layer of the affected skin areas. The macerative skin areas peel off in shreds and leave a highly red erosive area.

Complication(s)
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Keratolysis of the horny layer provides bacteria with an entry port into the skin, which can lead to erysipelas or gram-negative foot infections.

General therapy
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  • Informing the patient about the factors that favour this. In case of foot infestation, careful foot hygiene, changing and boiling out the socks daily, open, breathable footwear (e.g. breathable leather or Goretex).
  • It is important to disinfect the shoes with disinfectants, e.g. with Sagrotan Spray or Canesten Spray, if necessary buy new shoes.
  • Prophylactic wearing of bathing sandals in public swimming pools, saunas and showers.
  • In case of hand infestation, clarification and elimination of the cause, e.g. change in washing behaviour or detergents (wet work with alkaline detergents).

External therapy
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  • Dry out the interdigital rooms with linen cloths and dry brushes or foot baths with aqueous antiseptic solutions.
  • Antimycotic therapy with azole-containing creams / ointments, e.g. with 1-2% clotrimazole (e.g. Canesten, Canifug), 2% miconazole (e.g. Vobamyk, Daktar, R172 ) or 1% bifonazole (mycospor).

Literature
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  1. Schlager E et al (2018) Erosio interdigitalis blastomycetica: A review of interdigital candidiasis.
    Dermatol Online J 24 (8).
  2. Seebacher C et al (2006) Candidosis of the skin. J Dtsch Dermatol Ges 4: 591-596

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020