Tinea manuum | |
---|---|
Other names | Tinea manus [1] |
Tinea manuum hand | |
Specialty | Dermatology, infectious diseases |
Symptoms | Diffuse scaling, itch and prominent creases on palms [2] |
Complications | Secondary bacterial infection [3] |
Causes | Trichophyton rubrum [2] |
Risk factors | Diabetes, high blood pressure, weak immune system, humid surroundings, excessive sweating, recurrent hand trauma and cracks, pet owners, farmworkers. [3] |
Diagnostic method | Visualization, direct microscopy, culture [3] |
Treatment | Topical or oral antifungals [3] |
Medication | Terbinafine, itraconazole, clotrimazole, fluconazole, ketoconazole [3] |
Tinea manuum is a fungal infection of the hand, mostly a type of dermatophytosis, often part of two feet-one hand syndrome. [2] [4] There is diffuse scaling on the palms or back of usually one hand and the palmer creases appear more prominent. [2] When both hands are affected, the rash looks different on each hand, with palmer creases appearing whitish if the infection has been present for a long time. [5] It can be itchy and look slightly raised. [5] Nails may also be affected. [5]
The most common cause is Trichophyton rubrum. [2] The infection can result from touching another area of the body with a fungal infection such as athlete's foot or fungal infection of groin, contact with an infected person or animal, or from contact with soil or contaminated towels. [5] Risk factors include diabetes, high blood pressure, weak immune system, humid surroundings, excessive sweating, recurrent hand trauma and cracks in feet. [3] Pet owners and farmworkers are also at higher risk. [5] Machine operators, mechanics, gas/electricity workers and people who work with chemicals have also been reported to be at greater risk. [6]
Diagnosis is by visualization, direct microscopy and culture. [3] Psoriasis of the palms, pompholyx and contact dermatitis may appear similar. [3] Treatment is usually with long-term topical antifungal medications. [5] If not resolving, terbinafine or itraconazole taken by mouth might be options. [5]
It occurs worldwide. [3] One large study revealed around 84% of tinea manuum was associated with athlete's foot, of which 80% admitted scratching their feet, and 60% were male, [6]
There is usually an itch, with generalised dry flaky thick skin of the palm of a hand. [3] Frequently, one hand is affected, but it can be in both. [3] If the back of the hand is affected, it may appear as reddish circles like in ringworm. [3] Sometimes there are no symptoms. [3] The feet may be affected as in two feet-one hand syndrome. [2]
The most common cause is Trichophyton rubrum. [2] Other causes include Trichophyton verrucosum (from cattle), Microsporum canis (from a cat or dog), Trichophyton erinacei (from a hedgehog), Trichophyton mentagrophytes, Epidermophyton floccosum, Trichophyton interdigitale, and more rarely Microsporum gypseum, Trichophyton eriotrephon, and Arhroderma benhamiae. [3] [5]
Tinea manuum can result from touching another area of the body with a fungal infection such as athlete's foot or tinea cruris, contact with an infected person or animal, or from contact with soil or contaminated towels. [5]
Diabetes, high blood pressure, weak immune system, humid surroundings, excessive sweating, recurrent hand trauma and cracks in feet are risk factors for tinea manuum. [3] Pet owners and farmworkers are also at higher risk. [3] [5]
Diagnosis is by visualization, direct microscopy and culture. [3]
Psoriasis of the palms, pompholyx and contact dermatitis may appear similar. [3]
Prevention is focussed on hygiene such as washing hands, avoiding scratching the feet or touching fungal toe infections. [3]
Treatment is usually with long-term topical antifungal medications. [5] If not resolving, terbinafine or itraconazole by mouth might be options. [5] Other options include clotrimazole, fluconazole and ketoconazole. [3]
Tinea manuum is most common in young adult males. [3] Dermatophyte infections occur in up to a quarter of the world's population, of which the hands and feet are most commonly involved. [3] It occurs worldwide. [3] One large study revealed around 84% of tinea manuum was associated with athlete's foot, of which 80% admitted scratching their feet, and 60% were male, [6]