Many people develop athlete`s foot (tinea pedis) before tinea manuum. Because the fungus is so spread, you can spread the infection from your feet to your hands after scratching your feet. The most common symptoms of tinea manuum are itching, round patches on the back of the hand On lighter skin, the spots may appear red or pink. On darker skin, the spots may appear brown or gray. Patches can evolve into a series of rings or circles with central clearings. The rings may have raised, scaly edges. Fungal infections affect up to 25% of the world`s population. Tinea manuum and tinea pedis are the most commonly diagnosed fungal infections. Depending on the geographical location, tinea manuum is the diagnosis in up to 13% of fungal infections. Tinea manuum does not usually require this level of treatment, but tinea capitis, tinea unguium, and chronic tinea pedia are more difficult to clear up with topical treatments alone. Diagnosis of fungal infection is made by culture or direct microscopic visualization of fungal hyphae in dandruff after treatment with potassium hydroxide. Most skin dermatophytic infections can be treated with a 4-week course of topical antifungal medications.
Affected areas should be kept as dry as possible, especially the mesh spaces in the groin and toes. Exceptions to topical treatment are tinea unguium, tinea capitis, and often tinea manuum and granuloma majocchi, which require oral antifungal medications. Until recently, the only approved remedy for treating dermatophyte skin infections was griseofulvin, which is very effective for scalp and skin infections. A dose of 3.3 mg/kg/day of griseofulvin, once or twice daily for 4 to 6 weeks, is usually curative. However, nails are best treated with itraconazole. Since the drug is retained in the nail plate for a long period of time, controlled studies support a pulsed diet of 200 mg twice daily for 1 week of each month; However, current Food and Drug Administration (FDA) guidelines recommend a dose of 200 mg/day for 3 months. Other active ingredients reviewed by the FDA for use in onychomycosis include fluconazole and terbinafine. In patients with tinea pedis and onychomycosis, tinea pedis recurrence is common if the nails are not treated equally, often requiring unspecified topical treatment. The differential diagnosis of tinea manuum includes various skin conditions as well as bacterial, viral and fungal infections. A case study of tinea manuum collected showed that “two-foot one-handed syndrome” is the most common clinical presentation (65%), followed by bilateral tinea pedis with bilateral tinea manuum (19.3%), unilateral tinea manuum (11.8%) and bilateral tinea manuum (3.9%). [3] Mild tinea manuum is treated with topical antifungals, but if treatment fails, oral antifungal medications may be considered, including terbinafine and itraconazole.
In tinea manuum, the hands may take on a more diffuse appearance with a clearly defined erythema background. You can get tinea manuum after touching an animal that has the infection. Many different animals can spread tinea manuum. This includes pets such as dogs and cats (especially puppies and kittens). This also includes farm animals such as cows, horses, pigs and goats. Tinea manuum also spreads very easily. You can get tinea manuum if you come into contact with infected people, animals and soil. You can also get tinea manuum by using objects and touching the surfaces that harbor the fungus. Tinea manuum can live for a long time on infected objects and surfaces.
Diabetes, high blood pressure, weak immune system, humid environment, excessive sweating, recurrent trauma to the hands and cracks in the feet are risk factors for tinea manuum. [3] Pet owners and farm workers are also at higher risk. [3] [5] Although tinea manuum can occur in both hands, it now often affects only one hand (tinea manus). “Two feet, one hand syndrome” is the informal name for the most common diagnosis of tinea on the hands and feet. This means that tinea pedis affects both feet and tinea manus affects one hand. This condition occurs in 65% of cases. Fungal infections on the hands and feet occur in about 20% of cases. Tinea manus occurs on the one hand in almost 12% of cases. Tinea manuum on both hands occurs in about 4% of cases.
More commonly, tinea manuum causes a slowly expanding area with peeling, dryness and mild itching on the palm (hyperkeratotic tinea). Skin marks may be elevated. In general, both feet look similar (“two-hand syndrome”). The usual cause is an anthropophilic (human) fungus: Tinea manuum often occurs in athlete`s foot (Tinea pedis). But it can affect your hands alone. Drug interactions may occur. Careful monitoring of the entire blood count and liver function is recommended, especially if there is a risk of hepatitis or if treatment lasts longer than 3 months. In patients with tinea pedis and onychomycosis, recurrence of tinea pedis is common if the nails are not treated at the same time, often requiring unspecified topical treatment (Merck Manual, 2011).
You should call your doctor if the infection persists. You will be able to correctly diagnose your condition and recommend the appropriate treatment. You may need a prescription antifungal if the infection doesn`t go away. It may take a while, but tinea manuum infections eventually go away. Although fungi are the exact cause of tinea infections, you may be wondering how you come into contact with these organisms in the first place. Tinea infections are contagious, so if you have ringworm on another part of your body and touch it, you can develop a tinea manuum infection on your hand. Oral medications are usually reserved for infections that occur on multiple areas of the body at once, such as one hand and two feet. Some of the medications that may be prescribed for systemic treatment of tinea infection include: One case of contractures of non-use of flexor tendons has been reported in a patient with tinea manuum and irritant contact dermatitis. [7] Your doctor will ask about your symptoms and perform a physical exam. You will look at your palms, the backs of your hands and your fingers. Your supplier can also look at your feet.
This is because many people with tinea manuum also have tinea pedis. Clinical manifestations include diffuse hyperkeratosis of the fingers and palm and less frequent uneven inflammatory or vesicular reaction. Nail involvement (onychomycosis, see below) is common and may be an indication of the diagnosis. When onychomycosis is present, it usually affects some, but not all, of the nails of the affected hand. Total nail involvement, if any, should indicate possible diagnoses of psoriasis or lichen planus. The differential diagnosis of tinea manuum includes psoriasis, allergic or irritant contact dermatitis, dyshidrosis, and ID reaction. Unilateral involvement may be another indication of the diagnosis, which can be confirmed by microscopic KOH examination or fungal culture. Several topical and systemic antifungal options and therapies are available. Whenever possible, topical treatment of tinea manuum is preferable because of the risk of drug interactions and side effects of oral treatments. Tinea pedis, or athlete`s foot, has four common presentations (Figure 22-4). The interdigital form is the most common.
It begins with peeling, erosion and erythema of the interdigital and subdigital skin of the feet. The infection can spread to the adjacent sole or instep. If it is the dorsal aspect, it is considered tinea corporis. Bacterial occlusion and co-infection produce itching, bad odor and interdigital maceration. A second form, usually caused by T. Rubrum, has a moccasin-like distribution in which the plantar skin becomes scaly, with hyperkeratosis and erythema confined to the thick skin, soles of the feet and lateral and medial aspects of the feet.