Clinical Update: Terbinafine, steroid conquer tinea

By Dr Ian McColl

VESICLES on the sole of the foot, if unilateral, strongly suggest vesicular tinea. Scaling like this should alert you to the possibility of a tinea infection.

The vesicles are due to a type IV delayed hypersensitivity reaction to the fungal organism and, if florid enough, it can make it difficult to actually culture the fungus. This is often quite itchy. It requires the use of a fungicidal cream such as terbinafine plus a strong steroid cream to reduce the inflammatory reaction and relieve the itch. 

If there is no itch just use the terbinafine cream on its own and it will help the body’s immune system remove the fungus. Cream should be used for a month bd to make sure the fungus is gone, then applied perhaps once a week in the longer term to prevent reinfection. Localised pustules on the instep are more suggestive of localised pustular psoriasis.

www.skinconsult.com.au

This article first appeared in Medical Observer on the 30th of October, 2015

VESICLES on the sole of the foot, if unilateral, strongly suggest vesicular tinea. Scaling like this should alert you to...

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