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Tinea manuum

Tinea manuum is the name given to infection of one or both hands with a dermatophyte infection. It is much less common than tinea pedis (tinea affecting the foot).

Tinea manuum is frequently misdiagnosed because it appears similar to:

Clinical features of tinea manuum

Tinea manuum can occur as an acute inflammatory rash like tinea corporis. There is usually a raised border and clearing in the middle (ringworm). This is most likely when a zoophilic (animal) or geophilic (soil) fungus is responsible. The likely fungi are:

More frequently, tinea manuum causes a slowly extending area of peeling, dryness and mild itching on the palm of one hand (hyperkeratotic tinea). Skin markings may be increased. Generally both feet appear similar ("one hand, two foot syndrome"). The usual cause is an anthropophilic (human) fungus:

These fungi may also cause a blistering rash on the edges of the fingers or palm. The blisters appear in crops and contain a sticky clear fluid. They may have a peeling edge. This form of tinea manuum itches and burns.

Predisposing factors for tinea manuum

Tinea manuum results from:

It is more likely in those doing manual work, who sweat profusely (hyperhidrosis) or who already have hand dermatitis.

Distinguishing features of tinea manuum

Tinea manuum can be distinguished from hand dermatitis:

Diagnosis of tinea manuum

The diagnosis of tinea manuum is confirmed by microscopy and culture of skin scrapings.

Treatment of tinea manuum

Mild tinea manuum is treated with topical antifungal agents, but if the treatment is unsuccessful, oral antifungal medicines may be considered, including terbinafine and itraconazole.

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