Athlete's foot/"ringworm"

I have a large patch of itchy, flaking skin on the sole of my foot.  I've also developed blisters there and around my toes.  It's now red raw I've scratched it so much.  Assuming it was Athlete's Foot, I tried a couple of over-the-counter topical treatments, neither of which made any difference.  I've now also got lots of little vesicles on my hands - also insanely itchy and very unsightly.

I saw a nurse this morning who diagnosed Athlete's Foot and gave me a single tablet of 150mg Fluconazole.  Reading the packaging this is a one shot treatment for virginal thrush (!).  She also gave me some foot powder to apply to shoes etc.  

My questions are: (1) is this an appropriate treatment? (2) If so, how long will it take to have an effect (I can bare the itchyness no longer!).  (3) should I throw shoes, socks and so forth away when the infection has gone to prevent re-occurance?  (4) Do my hands have ringworm, or do I have a rash or allergic reaction to the fungus?  It seems odd that both hands have it, but only one foot.

[Bhupinder Kaur, MD]

Hello,
From the symptoms it can be pompholyx. The exact cause is not known and excessive sweating can be one of the reasons. But some triggers like allergic reaction to soaps, detergents, foods, latex, nickel etc may trigger the symptoms. Apply some calamine lotion on the affected area and keep the area well moisturized. Use only thin applications of moisturizer ointments as excessive amounts of ointment may restrict breathing of the skin and aggravate the condition.

Topical steroids can be applied but they are available under prescription. Moreover to prevent infection, topical antibiotics may be needed. I suggest you to consult a dermatologist and get it evaluated.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.