Streptococci do not ordinarily survive on normal skin, but the presence of fungal disease apparently permits streptococci of various groups, including A, B, C, and G, to colonize the toe webs. From this location, these bacteria may invade the skin damaged by the tinea pedis, or they may migrate to locations higher up the leg and enter the skin through any defects. Tinea Unguium Involvement of the nails usually occurs from adjacent fungal infection of the hands or feet. The organisms typically invade the nail from the distal or lateral borders, and infection spreads proximally. The nails are thickened, opaque, and yellowish to brownish.
Splinter hemorrhages are common.
Tinea Manuum Tinea manuum is infection of the hands. The most common finding is scaling or hyperkeratosis of the palms and fingers. Occasionally, vesicles, papules, or follicular nodules are present on the dorsal surface of the hands. Patients with skin lesions that are suspected of having been caused by dermatophytes should be asked about contact with animals. The diagnosis can be confirmed by microscopy or culture of properly obtained specimens.