RASHES - Foot - Common Patterns Adult

1)      Tinea pedis – toe web maceration,

2)      Atopic eczema

3)      Non-eczematous dermatitis

4)      Pitted keratolysis

5)      Onychomycosis – nail discoloration (white, brown), usually spread from nail edge towards the lunula of the nail, advancing along the lateral edges, sometimes total white discoloration of the nail, fissure formation in the nails, brittle, friable, thick nails, subungual debris, breakdown of the nail plate, Mx – Terbinafine (for dermatophyte infection, 250 gm daily for 6/52 for finger nail and 12/52 for toe nail infections, shorter courses and pulse dosing studied now, monitoring with FBC, ALT and AST levels baseline and then monthly recommended, prescribe only for healthy individuals), Itraconazole (dermatophytes, nondermatophytes, candida infections, fatal interaction with statins, diazepam, 200 mg daily for 6/52 finger nail infections and 12/52 for toe nail infections, monitoring with AST and ALT levels baseline and monthly, prescribe only for healthy individuals), Fluconazole (widespectrum like itraconazole, finger nail infection 200-400 mg once weekly for 3/12 and 6/12 for toe nails, monitoring not necessary, prescribe only for healthy individuals), managing predisposing conditions like tinea pedis, avoid foot maceration in tight footwear, keep feet dry always, wearing cotton socks.

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