Fungal foot infection, cellulitis and diabetes: a review

Area of Science:

• Dermatology
• Infectious Diseases
• Podiatry

Background:

• Fungal infections of the foot, including tinea pedis and toenail onychomycosis, are common.
• Cellulitis is a bacterial skin infection that can affect the lower limbs.
• The potential role of fungal foot infections as a precursor to cellulitis, particularly in diabetic patients, requires investigation.

Purpose of the Study:

• To systematically review existing evidence on fungal foot infections as a risk factor for lower limb cellulitis.
• To assess the specific risk in individuals with diabetes mellitus.

Main Methods:

• A structured literature search was conducted across Medline, Embase, and Cinahl databases.
• Studies investigating the association between fungal foot infection and cellulitis were identified and reviewed.
• Included studies were analyzed for methodology, diagnostic criteria for fungal infection, and reported outcomes.

Main Results:

• Sixteen studies met the inclusion criteria, predominantly case-control and cross-sectional designs.
• Most studies suggested a correlation between fungal foot infection and cellulitis, but often used clinical diagnosis.
• Only two case-control studies utilized microbiological confirmation, indicating fungal foot infection, especially interdigital tinea, as a risk factor for lower limb cellulitis.
• Insufficient data were found to establish an increased risk for diabetic patients.

Conclusions:

• Current evidence suggests a potential link between fungal foot infections and the development of lower limb cellulitis.
• Further high-quality research with microbiological confirmation is necessary to validate these findings and quantify the risk, particularly in the diabetic population.
• Enhanced clinical vigilance and prompt treatment of foot tinea infections are recommended to mitigate potential complications.