American Medical Association Family Medical Guide - American Medical Association [766]
Treatment
Tinea infections, especially athlete’s foot and jock itch, can usually be treated with an over-the-counter antifungal cream. Applying the cream twice a day for 2 to 4 weeks usually clears up the infection.
Your doctor will recommend self-help measures to help clear up the infection and to prevent recurring infections. For example, he or she will recommend drying your skin thoroughly (especially in the groin area and between your toes) after taking a bath or shower. Throw out worn-out shoes that might have fungal spores in them, especially if you have worn them without socks. Wear absorbent socks made of natural fibers (such as cotton) and change them daily. If the over-the-counter preparation you are using is not effective, your doctor may recommend another one.
In severe cases or for tinea infections on parts of the body other than the feet or groin (which can be harder to treat), a doctor may prescribe an oral antifungal medication.
Prevention
Keeping your skin clean and dry is the best protection against the tinea fungus. The following steps also can help you avoid a tinea infection:
• Change your socks and underwear every day, especially in warm weather.
• Try not to wear thick clothing for long periods in warm weather.
• In hot weather, wear sandals, open shoes, or shoes made of a breathable material that expose your feet to the air and allow perspiration to evaporate; go without shoes at home.
• Air out your shoes well between wearings.
• Avoid walking barefoot over surfaces (such as locker-room floors) on which the fungus often grows; use rubber sandals or shower shoes.
• Don’t share towels, bathmats, or nail clippers with someone who might have athlete’s foot.
• Throw out worn-out athletic or walking shoes, and never wear anyone else’s shoes.
• Check your pets for areas of fur loss, and have your veterinarian check them regularly.
• Use a topical athlete’s foot cream for about a week if you live with or have been in close contact with someone who has athlete’s foot.
Cutaneous Anthrax
Cutaneous, or skin, anthrax is an uncommon infection of the skin by a spore-forming bacterium called Bacillus anthracis. The infection is most common in wild and domestic livestock (including cattle, sheep, and goats), but infections also can occur in humans. Cutaneous anthrax infections develop most frequently in people whose occupations expose them to infected animals or animal products (such as wool, hides, or hair)—including farm workers, veterinarians, and tannery and wool workers. However, outbreaks of skin anthrax also have occurred as a result of acts of bioterrorism (see page 30) in which letters intentionally contaminated with anthrax spores were sent through the mail. Treatment clears up nearly all cases of skin anthrax. If not treated, however, in one in five cases the infection can spread through the bloodstream and be fatal.
Symptoms and Diagnosis
Within about 2 weeks of contact with the anthrax bacterium, an itchy skin sore develops that looks like a mosquito bite. The area around the sore usually is swollen. The sore forms a blister and then an ulcer (open sore), which develops a black scab (see page 125) that dries and falls off within a couple of weeks. In some cases, a fever and headache develop, and lymph nodes in the area of the infection become swollen and painful.
To diagnose skin anthrax, a doctor performs a biopsy, in which a sample from a sore is examined under a microscope to look for the anthrax bacterium.
Treatment
If you have cutaneous anthrax, your doctor will prescribe one of several oral antibiotics that are effective against the bacterium, such as penicillin, doxycycline, or ciprofloxacin. (During a suspected outbreak, ciprofloxacin is the antibiotic that is likely to be prescribed.) You probably