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Q. My daughter has fissured and cracked toe. What is the cause and treatment for it?

Answered by
Dr. Dhepe Snehal Laul
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Aug 28, 2021

Hi doctor,

My daughter is 6-years-old. She has had fissures and cracks in her big toes for four months. The skin over the toe is dry and peels off. I thought it was a fungal infection and used Canesten cream and Lamisil cream twice daily for two months. But it resulted in deep cracks. Then I consulted a doctor; she prescribed Diprosalic ointment and Allergika cream for ten days. Now the skin became soft but still peeling. I mix olive oil, oregano oil, and carrier oil and apply it on her skin, wrap it up to increase the absorption. But it remains dry.

Now my queries are;

1) What is this condition called?

2) What are the causes?

3) Should she wear socks all the time?

4) What type of slippers are good?

5) Is it a fungal infection?

Kindly help.

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#

Hello,

Welcome to icliniq.com.

This type of skin reaction is tinea pedis with palmoplantar keratoderma. I suggest you to apply Luliconazole cream (Luliact cream) twice daily in morning and night for two months and apply Miconazole ointment (Micogel) in evening at the site of cracks and fissures for one month. Kindly keep the area dry and clean as moisture favors the fungal growth. Wear comfortable non-occlusive foot-wear and avoid wearing socks. Do not scratch or rub the lesions as it may cause secondary bacterial infection.

Kindly answer me the following;

1) Are the lesions itching?

2) Does it spreads anywhere in the body?

3) Does she have pain while walking?

Revert with the answers.

Thanks.

Hello doctor,

Thanks for the reply.

The answers are as follow:

1) The lesion does not itch.

2) It is not spreading.

3) Do not cause pain in walking.

Kindly answer my queries,

1) What causes palmoplantar keratoderma?

2) What are the symptoms?

3) Is this severe and contagious?

4) Is tinea pedis contagious?

5) How can we avoid it?

6) Can she wear socks inside the house or walk barefoot?

Kindly help.

#

Hi,

Welcome back to icliniq.com.

The following are the answers to your questions;

1) The causes of tinea pedis can be exogenous factors like irritants, allergens, or an infection and endogenous factors like atopy.

2) Fungal infections are contagious, hence avoid sharing personal belongings and avoid contact with water.

I suggest to clean the area with soap and lukewarm water, pat dry it and then apply the cream.

Kindly maintain a good hygiene to promote healing.

Thanks.

Hello doctor,

Thanks for the reply.

1) Can she wear socks at home or a slipper from synthetic material like crooks shoes?

2) Can we put the powder in the socks?

3) Is it contagious if she walks barefoot?

4) When could it be contagious because the skin surface is dry without discharge?

Thanks again.

#

Hello,

Welcome back to icliniq.com.

Yes, she can wear thin cotton socks and comfortable slippers.

Kindly avoid occlusive wear, wet socks, conditions that cause sweating and retain moisture as moisture favors fungal growth.

I suggest you use Candid dusting powder (Clotrimazole) twice daily to avoid sweating.

Thanks.

Hi doctor,

Thanks for the response.

1) Is it possible to control palmoplantar keratoderma and when to expect a cure?

2) Is keratoderma contagious, and can it worsen further?

3) How to avoid skin thickening?

4) Shall we use moisturizer?

Kindly give your suggestion.

#

Hi,

Welcome back to icliniq.com.

It is advisable to treat the fungal infection primarily as it is spreading. We can treat the dry scaling skin (keratoderma) later.

Thanks.

Hello doctor,

Is there any alternative for the Luliact cream? As we already have Canesten and Nizoral cream, Can you give an alternative for Luliact?

Which area of the foot is showing the fungus? Is it the cut of the skin or the dry white area?

Where should I apply the cream?

All the toes area?

#

Hello,

Welcome to back to icliniq.com.

You can use Terbest cream (Terbinafine) instead of Luliact cream.

Thanks.

Hi doctor,

Thanks for the reply.

Could you please show the exact site of the infection in the picture that I have sent? Which part of her feet shows keratoderma?

Thanks.

#

Hi,

Welcome back to icliniq.com.

The scaly and fissured part is keratoderma rest is tinea pedis (attachments removed to protect the patient’s identity).

Regards.

Hello doctor,

Thanks for the response.

Can I send you weekly update of the lesion? And when shall I expect a complete cure?

Thanks.

#

Hello,

Welcome back to icliniq.com.

Kindly apply the cream mentioned above twice daily for two weeks. And revert after seven days.

Thanks.

Hello again
I have three questions:
1.Can I mix antifungul cream with any emollient because the area is dry and peeling?
2. After applying the cream, can she wear socks directly? I noticed that the socks absorb the cream? Or she need to sit for 10 minutes and then wearing socks?
3. Her toes are dry and no fluids or white blisters. How it could be contagious? The dry scales contagious?
Thank you dear
# Don't mix cream.

Yes ,you can wear thin cotton socks 30 min after application.

Fungal infection is contagious.

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