Tinea manuum

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]

Tinea manuum
Other namesTinea manus[1]
Tinea manuum hand
SpecialtyDermatology, infectious diseases
SymptomsDiffuse scaling, itch and prominent creases on palms[2]
ComplicationsSecondary bacterial infection[3]
CausesTrichophyton rubrum[2]
Risk factorsDiabetes, high blood pressure, weak immune system, humid surroundings, excessive sweating, recurrent hand trauma and cracks, pet owners, farmworkers.[3]
Diagnostic methodVisualization, direct microscopy, culture[3]
TreatmentTopical or oral antifungals[3]
MedicationTerbinafine, itraconazole, clotrimazole, fluconazole, ketoconazole[3]

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 athletes 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 athletes foot, of which 80% admitted scratching their feet, and 60% were male,[6]

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