Why the 4th interdigital space for tinea pedis more than the others?

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The reason for the 4th interdigital space (IDS) is the most effected (anecdotal) is?
It was suggested as the 5th digit is internally rotated (transverse plane) results in restricted IDS? any others? thanks, mark

 

bump ..... hasn't anyone thought about this before?

 

I think about it every morning as I apply my lamasil cream. I just never thought to ask why!

 

That`ll be why. Think; vehicle....not that I believe for one minute that you have chronic I/D TP, Bill.

Chronic tinea in the webspace is often polymicrobial; candida, t-rubrum, pseudomonas, etc due to the dank (damp `n dark, for those not from Sussex) environment provided by a deeper cleft in the 4th webspace and the pts inabilty to keep it dry.

Top Ten Tip; dip a cotton bud in surgical spirit and twizzle it between toes.....

Sorry Mark, for the distinct lack of biomech explanation

Chin, chin :drinks

 

Thanks Blinda; never realised pseudomonas could be involved; they definitely didn't mention that one before; a 'deeper cleft' > i'll make a otoform interdigital wedge with all 4 interdigital spaces on a few unsuspecting pts and analyse; wouldn't have any ideas regarding the o/lysis of the hallucial distal LATERAL corner? mark

 

Clandestine research.

Other than possible associated thyroid disorders, probably the same pre-disposition for distolateral OM; micro-trauma. HAV/dorsiflexed hallux combined with poorly-fitted shoes can produce physiological weak adherence to the nail plate in the lateral aspect.


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