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The Incidence of Tinea Pedis in Diabetic versus Nondiabetic Patients with Interdigital Macerations

A Prospective Study

Bradford S. Legge, DPM ^*, John F. Grady, DPM  and Autum M. Lacey, BA 

^* Department of Podiatry, Jesse Brown VA Medical Center, Chicago, IL. Dr. Legge is now in private practice, Indianapolis, IN.
Department of Podiatry, Department of Veteran’s Affairs Chicago Westside, Chicago, IL.
Dr. William M. Scholl College of Podiatric Medicine, North Chicago, IL.

Corresponding author: Bradford S. Legge, DPM, Podiatry Associates of Indiana, PC, 5471 Georgetown Rd, Ste C, Indianapolis, IN 46254. (E-mail: bradleggedpm{at}hotmail.com)

Abstract

Background: We sought to determine the incidence of tinea pedis in patients with otherwise asymptomatic pedal interdigital macerations. Both diabetic and nondiabetic populations were compared. Age and body mass index were also examined for their significance.

Methods: Fungal cultures of skin scrapings from 80 patients (77 male and 3 female; mean age, 65 years) with interdigital macerations were performed; 40 patients had previously been diagnosed with type 2 diabetes and 40 did not have diabetes.

Results: Cultures revealed a 40% prevalence of tinea pedis in the total study population. The prevalence in the nondiabetic group was 37.5% and 42.5% for the diabetic group. This was not a statistically significant difference. Among patients with interdigital macerations that yielded positive fungal cultures, those in the nondiabetic group were 6.3 years older than those in the diabetic group. It was also observed that the nondiabetic patients with interdigital macerations yielding positive fungal cultures were 9.1 years older than patients with negative fungal cultures in the nondiabetic group.

Conclusion: The results of this study provide the practitioner with a guide for treating pedal interdigital macerations. Because the likelihood of a tinea pedis infection is 40%, it seems prudent to treat these macerations with an antifungal agent. In regard to age, the results suggest that as nondiabetic patients age, the likelihood of an otherwise asymptomatic interdigital maceration yielding a positive fungal culture increases, and that diabetic patients may be susceptible to interdigital fungal infections at a younger age than those without diabetes. (J Am Podiatr Med Assoc 98(5): 353–356, 2008)