(2) Treatment. Give sitz baths (bath in which hips and buttocks of patient
are the only parts under water) for infection in the genital area. If the area is acutely
inflamed, use cool Burow's solution 1:10,000 for several days before applying any
ointments. Any one of these medications can be used: Desenex ointment applied
twice daily; Tinactin; or Halotex 1 percent solution or cream. When bathing, rinse
away all soap and dry the skin thoroughly. Use drying powder two or three times daily
and be sure not to wear any rough clothing.
d. Tinea Pedis (Athlete's Foot)(Epidermophytosis).
(1) Description/characteristics. Tinea of the feet, an extremely common
acute or chronic skin problem, occurs on the palms of the hands and soles of the feet.
Two clinical forms of this skin problem are seen: filaments that are vegetative organs
and spores that do not contain chlorophyll and are parasitic. Classic lesions are
weeping vesiculations. There is also a noninflammatory type of lesion with small,
nonweeping vesicles in the plantar surface of the foot and the sides of the toes, both
very similar to dyshidrosis (deep eruption of blisters occurring primarily on the hands
and feet accompanied by intense itching). Some people appear to be more susceptible
than others to athlete's foot; however, the organisms that cause this disease are
probably present on most people's feet all the time. The disease usually begins on the
third and fourth interdigital spaces of the foot and then spreads to the planter surface of
the arch. The lesions are softened areas with scaling borders. Maceration and
moisture due to excessive sweating cause more skin lesions than fungi. Involved
toenails become thickened and distorted. Acute flare-ups are common during warm
weather. Tinea pedis may be confused with softening due to hyperhidrosis (excessive
sweating) or occlusive (obstructive) footgear and other skin eruptions.
(2) Treatment. To treat tinea pedis, begin by maintaining good foot hygiene.
Dry the skin between the toes thoroughly after bathing and rub away any macerated
skin. Routinely, use a bland powder on the affected area. Place cotton between the
toes at night. Aluminum chloride 30 percent concentration can be used to dry the area
and for its antibacterial properties. Other medications that can be used include
tolnaftate solution or cream (the best single topical agent), clotrimazole one percent
cream or solution, haloprogin one percent solution or cream, miconazale two percent
cream or one-half percent Whitfields ointment.
e. Tinea Versicolor.
(1) Description/characteristics. Tinea versicolor is a mild superficial
infection of the skin usually found on the body trunk. This skin infection is caused by
fungus. The affected area will not tan. This disease is not particularly contagious. It is
apt to occur frequently in patients who wear heavy clothing and perspire a great deal.
Epidemics may occur in athletes. Symptoms include mild itching, usually not
uncomfortable enough to bother most people. The lesions are velvety, chamois-colored
macules which may vary from 4 to 5 mm. The lesions are easily scraped off using a
fingernail. The lesions appear on the trunk, upper arms, neck, and face. They may
persist for years without notice. You should distinguish them from vitiligo and