Tinea manuum

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Tinea manuum
Other namesTinea manus [1]
Tinea manum.jpg
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]
TreatmentTopical 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]

Contents

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]

Signs and symptoms

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]

Cause

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]

Risk factors

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

Diagnosis is by visualization, direct microscopy and culture. [3]

Differential diagnosis

Psoriasis of the palms, pompholyx and contact dermatitis may appear similar. [3]

Prevention

Prevention is focussed on hygiene such as washing hands, avoiding scratching the feet or touching fungal toe infections. [3]

Treatment

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]

Epidemiology

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]

See also

Related Research Articles

<span class="mw-page-title-main">Tinea cruris</span> Medical condition

Tinea cruris, also known as jock itch, is a common type of contagious, superficial fungal infection of the groin and buttocks region, which occurs predominantly but not exclusively in men and in hot-humid climates.

<span class="mw-page-title-main">Athlete's foot</span> Skin infection caused by fungus

Athlete's foot, known medically as tinea pedis, is a common skin infection of the feet caused by a fungus. Signs and symptoms often include itching, scaling, cracking and redness. In rare cases the skin may blister. Athlete's foot fungus may infect any part of the foot, but most often grows between the toes. The next most common area is the bottom of the foot. The same fungus may also affect the nails or the hands. It is a member of the group of diseases known as tinea.

Dermatophyte is a common label for a group of fungus of Arthrodermataceae that commonly causes skin disease in animals and humans. Traditionally, these anamorphic mold genera are: Microsporum, Epidermophyton and Trichophyton. There are about 40 species in these three genera. Species capable of reproducing sexually belong in the teleomorphic genus Arthroderma, of the Ascomycota. As of 2019 a total of nine genera are identified and new phylogenetic taxonomy has been proposed.

<span class="mw-page-title-main">Tinea corporis</span> Medical condition

Tinea corporis is a fungal infection of the body, similar to other forms of tinea. Specifically, it is a type of dermatophytosis that appears on the arms and legs, especially on glabrous skin; however, it may occur on any superficial part of the body.

<span class="mw-page-title-main">Tinea capitis</span> Cutaneous fungal infection of the scalp

Tinea capitis is a cutaneous fungal infection (dermatophytosis) of the scalp. The disease is primarily caused by dermatophytes in the genera Trichophyton and Microsporum that invade the hair shaft. The clinical presentation is typically single or multiple patches of hair loss, sometimes with a 'black dot' pattern, that may be accompanied by inflammation, scaling, pustules, and itching. Uncommon in adults, tinea capitis is predominantly seen in pre-pubertal children, more often boys than girls.

<span class="mw-page-title-main">Dermatophytosis</span> Fungal infection of the skin

Dermatophytosis, also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected. Symptoms begin four to fourteen days after exposure. Multiple areas can be affected at a given time.

<span class="mw-page-title-main">Onychomycosis</span> Medical condition

Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Fingernails may be affected, but it is more common for toenails. Complications may include cellulitis of the lower leg. A number of different types of fungus can cause onychomycosis, including dermatophytes and Fusarium. Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function. The diagnosis is generally suspected based on the appearance and confirmed by laboratory testing.

<span class="mw-page-title-main">Sertaconazole</span> Antifungal medication

Sertaconazole, sold under the brand name Ertaczo among others, is an antifungal medication of the Benzothiophene class. It is available as a cream to treat skin infections such as athlete's foot.

<span class="mw-page-title-main">Butenafine</span> Chemical compound

Butenafine, sold under the brand names Lotrimin Ultra, Mentax, and Butop (India), is a synthetic benzylamine antifungal. It is structurally related to synthetic allylamine antifungals such as terbinafine.

<i>Trichophyton rubrum</i> Species of fungus

Trichophyton rubrum is a dermatophytic fungus in the phylum Ascomycota. It is an exclusively clonal, anthropophilic saprotroph that colonizes the upper layers of dead skin, and is the most common cause of athlete's foot, fungal infection of nail, jock itch, and ringworm worldwide. Trichophyton rubrum was first described by Malmsten in 1845 and is currently considered to be a complex of species that comprises multiple, geographically patterned morphotypes, several of which have been formally described as distinct taxa, including T. raubitschekii, T. gourvilii, T. megninii and T. soudanense.

<i>Trichophyton</i> Genus of Fungi

Trichophyton is a genus of fungi, which includes the parasitic varieties that cause tinea, including athlete's foot, ringworm, jock itch, and similar infections of the nail, beard, skin and scalp. Trichophyton fungi are molds characterized by the development of both smooth-walled macro- and microconidia. Macroconidia are mostly borne laterally directly on the hyphae or on short pedicels, and are thin- or thick-walled, clavate to fusiform, and range from 4 to 8 by 8 to 50 μm in size. Macroconidia are few or absent in many species. Microconidia are spherical, pyriform to clavate or of irregular shape, and range from 2 to 3 by 2 to 4 μm in size.

The use of podiatry drills, in the absence of engineering controls and personal protective equipment, is an occupational hazard to the healthcare provider. Nail dust collected during foot care procedures performed in office settings has been found to contain keratin, keratin hydrolysates, microbial debris, and viable fungal elements, including dermatophytes and saprotrophs. Exposure to nail dust and the associated risk will vary with the policies and practices in place, the type of podiatry drill used, therapy technique, frequency of procedures, personal protective equipment utilized and the use of ventilation systems.

<span class="mw-page-title-main">Tinea imbricata</span> Medical condition

Tinea imbricata is a superficial fungal infection of the skin limited to southwest Polynesia, Melanesia, Southeast Asia, India, and Central America. The skin lesions are often itchy, and mainly in the torso and limbs. The name is derived from the Latin for "tiled" (imbricata) since the lesions are often lamellar. It is often treated with griseofulvin or terbinafine.

<i>Microsporum gypseum</i> Species of fungus

Microsporum gypseum is a soil-associated dermatophyte that occasionally is known to colonise and infect the upper dead layers of the skin of mammals. The name refers to an asexual "form-taxon" that has been associated with four related biological species of fungi: the pathogenic taxa Arthroderma incurvatum, A. gypsea, A. fulva and the non-pathogenic saprotroph A. corniculata. More recent studies have restricted M. gypseum to two teleomorphic species A. gypseum and A. incurvatum. The conidial states of A. fulva and A. corniculata have been assigned to M. fulvum and M. boullardii. Because the anamorphic states of these fungi are so similar, they can be identified reliably only by mating. Two mating strains have been discovered, "+" and "–". The classification of this species has been based on the characteristically rough-walled, blunt, club-shaped, multicelled macroconidia. Synonyms include Achorion gypseum, Microsporum flavescens, M. scorteum, and M. xanthodes. There has been past nomenclatural confusion in the usage of the generic names Microsporum and Microsporon.

Microsporum nanum is a pathogenic fungus in the family Arthrodermataceae. It is a type of dermatophyte that causes infection in dead keratinized tissues such as skin, hair, and nails. Microsporum nanum is found worldwide and is both zoophilic and geophilic. Animals such as pigs and sheep are the natural hosts for the fungus; however, infection of humans is also possible. Majority of the human cases reported are associated with pig farming. The fungus can invade the skin of the host; if it is scratched off by the infected animal, the fungus is still capable of reproducing in soil.

<span class="mw-page-title-main">Luliconazole</span> Chemical compound

Luliconazole, trade names Luzu among others, is an imidazole antifungal medication. As a 1% topical cream, It is indicated for the treatment of athlete's foot, jock itch, and ringworm caused by dermatophytes such as Trichophyton rubrum, Microsporum gypseum and Epidermophyton floccosum.

<i>Epidermophyton floccosum</i> Species of fungus

Epidermophyton floccosum is a filamentous fungus that causes skin and nail infections in humans. This anthropophilic dermatophyte can lead to diseases such as tinea pedis, tinea cruris, tinea corporis and onychomycosis. Diagnostic approaches of the fungal infection include physical examination, culture testing, and molecular detection. Topical antifungal treatment, such as the use of terbinafine, itraconazole, voriconazole, and ketoconazole, is often effective.

Two feet-one hand syndrome(TFOHS), is a long-term fungal condition where athlete's foot or fungal toe nail infections in both feet is associated with tinea manuum in one hand. Often the feet are affected for several years before symptoms of a diffuse scaling rash on the palm of one hand appear, which is when most affected people then seek medical help.

Topical antifungaldrugs are used to treat fungal infections on the skin, scalp, nails, vagina or inside the mouth. These medications come as creams, gels, lotions, ointments, powders, shampoos, tinctures and sprays. Most antifungal drugs induce fungal cell death by destroying the cell wall of the fungus. These drugs inhibit the production of ergosterol, which is a fundamental component of the fungal cell membrane and wall.

References

  1. Grossman, Sheila (2014). "61. Disorders of skin integrity and function". Porth's Pathophysiology: Concepts of Altered Health States (9th ed.). Lippincott Williams & Wilkins. p. 1545. ISBN   978-1-4511-4600-4.
  2. 1 2 3 4 5 6 7 Johnstone, Ronald B. (2017). "25. Mycoses and Algal infections". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 441. ISBN   978-0-7020-6830-0.
  3. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Chamorro, Monica J.; House, Steven A. (10 August 2020). "Tinea Manuum". StatPearls. StatPearls Publishing. PMID   32644474.
  4. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN   978-1-4160-2999-1.
  5. 1 2 3 4 5 6 7 8 9 10 11 12 "Tinea manuum". dermnetnz.org. Retrieved 27 September 2021.
  6. 1 2 3 McFadden, John; Puangpet, Pailin; Pongpairoj, Korbkarn; Thaiwat, Supitchaya; Lee, Shan Xian (2020). "8. Elimination or inclusion of non-allergic skin diseases". Common Contact Allergens: A Practical Guide to Detecting Contact Dermatitis. Hoboken: John Wiley & Sons. p. 104. ISBN   978-1-119-40571-9.