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Abstract: The child in this case developed foot peeling, yellowing and thickening of the toenails, and local itching and other uncomfortable symptoms more than 1 year ago, but did not pay attention together at that time. Recently, she came to our hospital and was diagnosed with tinea pedis and onychomycosis, and was prescribed topical medications for treatment according to the patient’s condition. After 9 months of treatment, the child’s tinea pedis and onychomycosis were cured one after another, and the uncomfortable symptoms disappeared.
Basic information】Female, 8 years old
Disease Type】Foot fungus (Tinea pedis)
Hospital】Hunan Provincial People’s Hospital
Date of consultation】June 2021
Treatment plan】Medication (amorolfine hydrochloride application, naftifine ketoconazole cream)
【Treatment period】1 day of outpatient treatment, discharged the patient with medication, 3 months of outpatient follow-up
Treatment effect] The condition was cured
I. Initial consultation
The child’s family described that the child’s feet had developed thickened and deformed nails and peeling skin on both feet without any cause about one year ago. The third and fourth toenails of the right foot were yellowed, thickened, and deformed, suggesting the presence of tinea pedis. After explaining to the child’s family, local dander and nail shavings were taken for fungal microscopy, and the diagnosis of tinea pedis was confirmed based on the microscopic findings.
II. Treatment history
After communicating with the child’s family, I learned that the child probably contracted tinea pedis by mixing foot towels with relatives at home. I reassured the family, explained to her that tinea pedis could be cured with persistent medication, and prescribed medications for the child, including amorolfine hydrochloride application, which is used to treat nail surface infections caused by sensitive fungi, and naftifine ketoconazole cream, which can be applied to the skin lesions on the feet to treat tinea pedis and effectively relieve the itching discomfort on the feet. The child’s family is also reminded to make sure to supervise the child’s medication and to change the shoes and socks regularly to avoid secondary infection of fungi during the medication process, which may affect the treatment effect.
Third, the treatment effect
After 3 months of treatment, the child recovered from tinea pedis. The scattered flaking on the foot and between the toes disappeared, and the child reported that her feet did not itch anymore, indicating that the previous antifungal treatment was effective. However, the third and fourth toenails of the right foot had not yet healed and continued medication was required, which was understood by the patient’s family. After an interval of about 6 months, the child came for a follow-up visit and the physical examination showed that the toenail had returned to its normal form and no fungus was detected, indicating a complete recovery.
IV. Precautions
After prescribing for the child, I reassured the family and explained to the child’s family that before using amorolfine hydrochloride application, the diseased toenail needs to be filed down and contact of the diseased toenail with the healthy toenail should be avoided. The foot towels, bath towels, nail clippers and other supplies should be used exclusively at home, and should not be mixed again, as this will not only affect the treatment of the child, but may also lead to cross-infection. In addition, the child should select shoes with good ventilation, and supervise the child not to scratch the foot with their hands, and should wash their hands immediately after touching the child’s foot to prevent cross-infection.
V. Personal insight
Although tinea pedis is common in adults, some children, like the child in this article, may also be indirectly infected by sharing toiletry items such as foot towels and foot soakers with adults. In particular, the child in this article did not come to the hospital until more than a year after the onset of symptoms, because tinea pedis does not heal on its own, so the late consultation made the subsequent treatment more difficult.