Athlete's Foot: Symptoms, risk factors, prevention and treatment

By Pamela Ogujiuba

Reviewed by Keno Ekpokpobe

Athlete's foot (Tinea pedis) is a fungal infection that affects the upper layer of the skin of the foot, and usually becomes apparent between the toes.

Athlete's foot is caused by a fungus called trichophyton, a parasitic variety that feeds on keratin, a protein found in hair, nails and skin. Trichophyton thrives mostly in dark environments, such as in dead upper layers of skin between the toes of a sweaty foot inside a tight enclosed shoe, their spores are extremely difficult to eliminate and spread everywhere.

 

Athlete's foot forms because there is a presence of fungus and bacteria. When the conditions become right for the bacteria or fungus to grow, usually in moist, warm places like in your shoes that's when the infection sets in. Athlete's foot most usually causes burning, stinging, redness and itching, and in some cases causes flaking of skin.

SYMPTOMS

Athlete's foot presents with lots of different symptoms, but you won't get all of them. However, the longer you have athlete's foot, the worse the symptoms are likely to be.

If you have athlete's foot, you may have the following symptoms;

·         Itchy, scaly, red rash between your toes

·         Small red blisters (usually occurring in the soles of your feet or between your toes)

·         Dryness and scaling on the soles of the feet

·         Ulcers that leak fluid, smell bad and look red

·         Stinging or burning sensation between the toes

In very extreme cases;

·         The skin on the soles of your feet may get thick, and look leathery and red.

·          You may have raised bumps on your feet, these can be very itchy.

·         Discolored, thick and crumbly toenails. Nails may fall off.

·         Skin damaged by athlete's foot can become infected with bacteria. This can lead to cellulitis.

TYPES OF ATHLETE'S FOOT

Toeweb Infection:

This is also known as interstitial infection, and is the most common type. It occurs between the fingers or toes. It usually emanates on the skin between your fourth and fifth toes. In this case, the skin may be red, peeling or scaly, and the rash may give a foul smell or produce discharge. In extreme cases, the skin is a green color.

Moccasin Infection: It is called moccasin infection if the fungus covers the sole of your feet. Early stages present with sore, dry or slightly itchy feet and subsequently the affected skin thickens and cracks or peels. Toenails may get thick and brittle, sometimes the nail falls off.

Moccasin infection is usually seen in people with eczema and asthma.

Vesicular Infection: This begins with an outbreak of fluid filled with vesicles(blisters) under the foot. This is usually on the bottom of the foot, but sometimes can appear anywhere on the foot.

Ulcerative Infection: This type is unusual, but feet develops open sores or ulcers. This ulcers are predisposed to infection by bacteria. In addition to sores that may produce discharge, skin gets inflamed and discolored.

RISK FACTORS

1. Weakened immune system, either by the prolonged use of steroids, chemotherapy or HIV infection.

2. Wearing tight fitting covered toe shoes.

3. Sweaty feet, keeping your feet wet for a long period of time.

4. Walking bare foot in a public area, especially swimming pools, showers.

5. Skin or nail injury

6. Sharing items that have been in contact with the fungus.

PREVENTION AND TREATMENT

Athlete's foot can be treated with over the counter topical antifungal which includes miconazole, terbinafine, clotrimazole. However, prescription medications are necessary if over the counter medications don't treat the infection.

They include;

* Oral antifungal medications such as Fluconazole, itraconazole.

*Topical steroid medications to reduce painful inflammation.

*Oral antibiotics if bacterial infection develops due to raw skin and blisters.

Athlete's foot can however be prevented, and can be done in the following ways;

1. Wash your feet with soap and water regularly, especially between the toes.

2. Avoid sharing socks, shoes or towels

3. Clad your feet in public showers, swimming pools and in other public places.

4. Change your socks when feet get sweaty.

5. Air your shoes and give time to dry, moisture is a medium for the fungus to thrive.

6. Wear socks made out of synthetic fibers and materials such as cotton or wool.

Athlete’s foot is generally not a harmful disease, as no mortality and morbidity has been recorded. However, it causes serious discomfort and embarrassment and should be avoided.

Breast cancer: Symptoms, risk factors, and treatment

By Keno Ekpokpobe

An early diagnosis of breast cancer increases the chance of recovery.

Breast cancer is the most common invasive cancer in women, and the second main cause of cancer death in women, after lung cancer.

Breast cancer can affect men too, but this article will focus on breast cancer in women.

Fast facts on breast cancer:

Here are some key points about breast cancer. More detail is in the main article.

• ·         Breast cancer is the most common cancer among women.

• ·         Symptoms include a lump or thickening of the breast, and changes to the skin or the nipple.

• ·         Risk factors can be genetic, but some lifestyle factors, such as alcohol intake, make it more likely  to happen.

• ·         A range of treatments is available, including surgery, radiation therapy and chemotherapy

• ·         Most breast lumps are not cancerous, but any woman who is concerned about a lump or change should see a doctor.

What is breast cancer?

After puberty, a woman's breast consists of fat, connective tissue, and thousands of lobules, tiny glands that produce milk for breast-feeding. Tiny tubes, or ducts, carry the milk toward the nipple.

In cancer, the body's cells multiply uncontrollably. It is the excessive cell growth that causes cancer.

Breast cancer can be:

• Ductal carcinoma: This begins in the milk duct and is the most common type.
• Lobular carcinoma: This starts in the lobules.

Invasive breast cancer is when the cancer cells break out from inside the lobules or ducts and invade nearby tissue, increasing the chance of spreading to other parts of the body.

Non-invasive breast cancer is when the cancer is still inside its place of origin and has not broken out. However, these cells can eventually develop into invasive breast cancer.

Symptoms

The first symptoms of breast cancer are usually an area of thickened tissue in the breast, or a lump in the breast or in an armpit.

Other symptoms include:

• a pain in the armpits or breast that does not change with the monthly cycle
• pitting or redness of the skin of the breast, like the skin of an orange
• a rash around or on one of the nipples
• a discharge from a nipple, possibly containing blood
• a sunken or inverted nipple
• a change in the size or shape of the breast
• peeling, flaking, or scaling of the skin on the breast or nipple

Most lumps are not cancerous, but women should have them checked by a health care professional.

Ten risk factors

Breast cancer usually starts in the inner lining of milk ducts or the lobules that supply them with milk. From there, it can spread to other parts of the body.

The exact cause remains unclear, but some risk factors make it more likely. Some of these are preventable.

1. Age

The risk increases with age. At 20 years, the chance of developing breast cancer in the next decade is 0.6 percent. By the age of 70 years, this figure goes up to 3.84 percent.

2. Genetics

If a close relative has or has had, breast cancer, the risk is higher. Women who carry the BRCA1 and BRCA2 genes have a higher risk of developing breast cancer, ovarian cancer or both. These genes can be inherited. TP53 is another gene that is linked to a greater breast cancer risk.

3. A history of breast cancer or breast lumps

Women who have had breast cancer before are more likely to have it again, compared with those who have no history of the disease.

4. Dense breast tissue

Breast cancer is more likely to develop in higher density breast tissue.

5. Estrogen exposure and breast-feeding

Being exposed to oestrogen for a longer period appears to increase the risk of breast cancer.

This could be due to starting periods earlier or entering menopause later than average. Between these times, oestrogen levels are higher.

Breast-feeding, especially for over 1 year, appears to reduce the chance of developing breast cancer, possibly because pregnancy followed by breastfeeding reduces exposure to oestrogen.

6. Body weight

Women who are overweight or have obesity after menopause may have a higher risk of developing breast cancer, possibly due to higher levels of oestrogen. High sugar intake may also be a factor.

7. Alcohol consumption

A higher rate of regular alcohol consumption appears to play a role. Studies have shown that women who consume more than 3 drinks a day have a 1.5 times higher risk.

8. Radiation exposure

Undergoing radiation treatment for a cancer that is not breast cancer increases the risk of breast cancer later in life.

9. Hormone treatments

The use of hormone replacement therapy (HRT) and oral birth control pills have been linked to breast cancer, due to increased levels of oestrogen.

10. Occupational hazards

In 2012, researchers concluded that exposure to certain carcinogens and endocrine disruptors, for example in the workplace, could be linked to breast cancer.

Diagnosis

A diagnosis often occurs as the result of routine screening, or when a woman approaches her doctor after detecting symptoms.

Some diagnostic tests and procedures help to confirm a diagnosis.

Breast exam

The physician will check the patient's breasts for lumps and other symptoms. The patient will be asked to sit or stand with her arms in different positions, such as above her head and by her sides.

Imaging tests

A mammogram is a type of x-ray commonly used for initial breast cancer screening. It produces images that can help detect any lumps or abnormalities.

An ultrasound scan can help differentiate between a solid mass or a fluid-filled cyst.

An MRI scan involves injecting a dye into the patient, so find out how far the cancer has spread.

Treatment

Treatment will depend on:

• the type of breast cancer
• the stage of the cancer
• sensitivity to hormones
• the patient's age, overall health, and preferences

Surgery

If surgery is needed, the choice will depend on the diagnosis and the individual.

Lumpectomy: Removing the tumor and a small margin of healthy tissue around it can help prevent the spread of the cancer. This may be an option if the tumor is small and likely to be easy to separate from the surrounding tissue.

Mastectomy: Simple mastectomy involves removing the lobules, ducts, fatty tissue, nipple, areola, and some skin. Radical mastectomy removes muscle from the chest wall and the lymph nodes in the armpit as well.

It could also be sentinel node biopsy, axillary lymph node dissection, reconstruction, radiation therapy or chemotherapy

Prevention

There is no sure way to prevent breast cancer, but some lifestyle decisions can significantly reduce the risk of breast and other types of cancer.

These include:

• avoiding excess alcohol consumption
• following a healthy diet with plenty of fresh fruit and vegetables
• getting enough exercise
• maintaining a healthy body mass index (BMI)

Women should think carefully about their options for breast-feeding and the use of HRT following menopause, as these can affect the risk.

Preventive surgery is an option for women at high risk.

Malaria

By Keno Ekpokpobe

What is malaria?

Malaria is a parasitic infection transmitted by the bite of female Anopheles mosquitoes. The parasite was visualized in red blood cells by Lavern in 1880. Sir Ronald Ross subsequently proved that the infection was transmissible by mosquitoes to humans in 1897.
Four species of the parasite transmit human malaria: Plasmodium vivax, P. falciparum, P. ovale, and P. malariae. P. vivax and P. falciparum together account for almost 90% of malaria infections globally.
P. falciparum, the most virulent form, is the cause of almost all malaria-associated deaths and severe disease.
P. vivax and P. ovale cause relapsing disease; relapses occur weeks to months after initial illness.

Fast facts on malaria:

• Only the Anopheles mosquito can transmit malaria.
• Malaria is spread by mosquitoes, and it cannot pass directly between people.
• Symptoms resemble those of flu, but, without treatment, the effects can sometimes be long-term and fatal.

Symptoms

Malaria symptoms can be classified into two categories: uncomplicated and severe malaria.

Uncomplicated malaria

This is diagnosed when symptoms are present, but there are no signs to indicate severe infection or dysfunction of the vital organs.

This form can become severe malaria if left untreated, or if the host has poor or no immunity.

Symptoms of uncomplicated malaria typically last 6 to 10 hours and recur every second day. Some strains of the parasite can have a longer cycle or cause mixed symptoms.

In uncomplicated malaria, symptoms progress as follows, through cold, hot, and sweating stages: a sensation of cold with shivering, fever, headaches, and vomiting, seizures sometimes occur in younger people with the disease, sweats, followed by a return to normal temperature, with tiredness

Severe malaria

In severe malaria, clinical or laboratory evidence shows signs of vital organ dysfunction.

Symptoms of severe malaria include:

Fever and chills, impaired consciousness, prostration, or adopting a prone position, multiple convulsions, deep breathing and respiratory distress, abnormal bleeding and signs of anaemia, clinical jaundice and evidence of vital organ dysfunction. Severe malaria can be fatal without treatment.

Causes

Malaria happens when a bite from the female Anopheles mosquito infects the body with Plasmodium. Only the Anopheles mosquito can transmit malaria.

The successful development of the parasite within the mosquito depends on several factors, the most important being humidity and ambient temperatures.

When an infected mosquito bites a human host, the parasite enters the bloodstream and lays dormant within the liver.

The host will have no symptoms for an average of 10.5 days, but the malaria parasite will begin multiplying during this time.

The new malaria parasites are then released back into the bloodstream, where they infect red blood cells and multiply further. Some malaria parasites remain in the liver and are not released until later, resulting in recurrence.

An unaffected mosquito becomes infected once it feeds on an infected individual. This restarts the cycle.

Diagnosis and tests

Early diagnosis is critical for a patient's recovery. Anyone showing signs of malaria should be tested immediately.

The World Health Organization (WHO) strongly advise confirmation of the parasite through microscopic laboratory testing or by a rapid diagnostic test (RDT), depending on the facilities available.

No combination of symptoms can reliably distinguish malaria from other causes, so a parasitological test is vital for identifying and managing the disease.

Prevention and Treatment  

Preventing mosquitoes from biting humans not only reduces the number of people who become infected with the malaria parasite, but also number of infected mosquitoes that can pass the parasite to new human hosts. Prevention can be accomplished by:

Reducing the mosquito population: Methods include killing mosquito larvae (larviciding), killing adult mosquitos through indoor residual spraying (IRS) and with insecticide-treated nets (ITNs) where coverage is sufficiently high, or eliminating breeding sites (source reduction) with various insecticides or biological measures.

Reducing human-mosquito contact (personal protection): Insecticide-treated nets (ITNs) are also a highly effective method for providing individual protection from malaria infection when used correctly and consistently. ITNs are the primary method for prevention of malaria
worldwide.

Treatment aims to eliminate the Plasmodium parasite from the patient's bloodstream. 
Those without symptoms may be treated for infection to reduce the risk of disease transmission in the surrounding population.

Artemisinin-based combination therapy (ACT) is recommended by the WHO to treat uncomplicated malaria. Artemisinin-based combination therapies (ACTs) are highly effective against P. falciparum, the most prevalent and lethal malaria parasite affecting humans.

Artemisinin is derived from the plant Artemisia annua, better known as sweet wormwood. It is known for its ability to rapidly reduce the concentration of Plasmodium parasites in the bloodstream.