| 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]