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Clinical Review Extracts from “Clinical Evidence”

Athlete's foot and fungally infected toenails

BMJ 2001; 322 doi: (Published 03 February 2001) Cite this as: BMJ 2001;322:288
  1. Fay Crawford, MRC fellow (fc5{at},
  2. Rachel Hart, research podiatristb,
  3. Sally E M Bell-Syer, research fellowa,
  4. David J Torgerson, senior research fellowa,
  5. Philip Young, lecturera,
  6. Ian Russell, professor of health sciencesa
  1. a University of York, York YO10 5DD
  2. b University of Wales Institute, Cardiff CF1 3NS
  1. Correspondence to: F Crawford


    Definition Athlete's foot is a cutaneous fungal infection that causes the skin to itch, flake, and fissure. Nail involvement is characterised by ungual thickening and discoloration.

    Incidence/prevalence: In the United Kingdom, athlete's foot is present in about 15% of the general population,1 and 1.2 million people have fungally infected toenails.2

    Aetiology/risk factors: Swimming pool users and industrial workers may have increased risk of fungal foot infection. However, one survey found fungal foot infection in only 8.5% of swimmers, with the highest incidence (20%) in men aged 16 years and over.1

    Prognosis: Fungal infections of the foot are not life threatening in people with normal immunity, but in some people they cause persistent symptoms. Other people seem to be oblivious of persistent infection. The infection can spread to other parts of the body and to other people.

    Aims: To control symptoms and prevent recurrence, with minimal adverse effects.

    Outcomes: Rates of fungal eradication, shown by negative microscopy and culture, and resolution of clinical signs and symptoms at follow up.


    • Competing interests None declared.

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