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Suggest Treatment For Painful Itchy Swollen Peeling Wounds Under Toes

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Posted on Mon, 6 Jul 2015
Question: The skin on my foot is peeling in between and under the toes are oozing red liquid, very painful, itchy and swollen.
doctor
Answered by Dr. Dr. Kakkar (31 minutes later)
Brief Answer:
Possibility of Tinea pedis Or pompholyx with secondary bacterial inf'n

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I understand your concern.

I request you to kindly upload an Image so that I am able to guide you better.

You may upload an Image either at "Reports Section"

Or else

You may mail me the Image at YYYY@YYYY with the subject line of this mail as Attn: Dr. Kakkar.

I suggest a possibility of Tinea/ Fungal infection i.e Tinea Pedis with superimposed bacterial infection AND a second possibility of pompholyx/ endogenous eczema with secondary bacterial infection.

Tinea Pedis is usually itchy. It commonly starts from the web spaces between toes and may extend to involve neighboring skin.
Skin involvement with tinea pedis may develop secondary bacterial infection and then it would become painful, swollen with oozing.

Pompholyx/ eczema, usually presents with itching and tense painful vesiculation on sides of toes and fingers.
Pompholyx may also become secondarily infected with bacteria and become swollen, painful and ooze pus and blood.

If I was the treating doctor I would start you on Oral antibiotics e.g Amoxycillin Or Cephalexin, thrice daily for a week. This would take care of bacterial superinfection and oozing.
An OTC painkiller e.g ibuprofen twice or thrice daily will provide you symptomatic relief from pain and discomfort.

Thereafter management would depend on whether the underlying condition is Tinea Or Pompholyx.

Tinea would require Oral and topical antifungals whereas pompholyx would require topical steroid cream with or without Oral steroids

I would like to know whether the condition affects all the toes? Is it on one side Or does it affect both the feet?

Regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Kakkar (18 minutes later)
At the present time, it's only on one foot, the previous time, which was back in 2011, both feet were affected.

I had difficulty taking the pictures, but even this action left the liquid dripping from my feet.
doctor
Answered by Dr. Dr. Kakkar (7 hours later)
Brief Answer:
Oral antibiotics for a wk; oral antifungals; topical antifungal after a wk.

Detailed Answer:
Hi.

Thank you though the Image is not very clear.
However the fact that it involves the toe web spaces and is unilateral suggests that this is primarily a fungal infection/ tinea pedis with superimposed bacterial infection.

I suggest that you be started on Oral antibiotics for a week. This would help resolve bacterial superinfection, oozing as well as swelling.

I would also suggest that you be started on oral antifungals e.g weekly fluconazole tablets for 4-6 weeks.

An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching & an OTC oral antiinflammatory e.g ibuprofen, twice daily, will provide you symptomatic relief from pain & swelling.

Along with Oral fluconazole, you may also use a topical antifungal e.g clotrimazole 1% cream, twice daily, once the area dries up after a week of Oral antibiotics.

Oral antifungals and Oral antibiotics are prescription products.
I suggest that you visit a dermatologist for a confirmatory diagnosis as well as for the needful. You may share this discussion with your dermatologist.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Kakkar (12 hours later)
I have attached a revised picture to see if your diagnosis would be the same. Thank you so much for your advice.
doctor
Answered by Dr. Dr. Kakkar (10 hours later)
Brief Answer:
Tinea Pedis with secondary bacterial infection

Detailed Answer:
Hi. Thank you. I have reviewed the new image. I will stick to my diagnosis I.e times pedis with secondary bacterial infection. Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Suggest Treatment For Painful Itchy Swollen Peeling Wounds Under Toes

Brief Answer: Possibility of Tinea pedis Or pompholyx with secondary bacterial inf'n Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I understand your concern. I request you to kindly upload an Image so that I am able to guide you better. You may upload an Image either at "Reports Section" Or else You may mail me the Image at YYYY@YYYY with the subject line of this mail as Attn: Dr. Kakkar. I suggest a possibility of Tinea/ Fungal infection i.e Tinea Pedis with superimposed bacterial infection AND a second possibility of pompholyx/ endogenous eczema with secondary bacterial infection. Tinea Pedis is usually itchy. It commonly starts from the web spaces between toes and may extend to involve neighboring skin. Skin involvement with tinea pedis may develop secondary bacterial infection and then it would become painful, swollen with oozing. Pompholyx/ eczema, usually presents with itching and tense painful vesiculation on sides of toes and fingers. Pompholyx may also become secondarily infected with bacteria and become swollen, painful and ooze pus and blood. If I was the treating doctor I would start you on Oral antibiotics e.g Amoxycillin Or Cephalexin, thrice daily for a week. This would take care of bacterial superinfection and oozing. An OTC painkiller e.g ibuprofen twice or thrice daily will provide you symptomatic relief from pain and discomfort. Thereafter management would depend on whether the underlying condition is Tinea Or Pompholyx. Tinea would require Oral and topical antifungals whereas pompholyx would require topical steroid cream with or without Oral steroids I would like to know whether the condition affects all the toes? Is it on one side Or does it affect both the feet? Regards