What is tinea manuum?
Who gets tinea manuum?
Tinea manuum results from:
- Contact with another site of infection, particularly the feet (tinea pedis) or groin (tinea cruris)
- Contact with another person with tinea
- Direct contact with an infected animal or soil
- Contact with a contaminated object such as a towel or gardening tool.
What causes tinea manuum?
Zoophilic and geophilic dermatophytes:
- Trichophyton erinacei — from a hedgehog
- T. verrucosum — from cattle
- Microsporum canis — from a cat or dog
- Nannizzia gypsea — from the soil.
- T. rubrum
- T. interdigitale
- Epidermophyton floccosum.
What are the 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 or geophilic fungus is responsible.
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.
Tinea manuum can be clinically distinguished from hand dermatitis.
- In most cases of tinea manuum, only a single hand is involved.
- If both hands are affected, involvement is asymmetrical.
- Increased skin markings can be seen in dermatitis, but in chronic tinea manuum, they are white because of surface scale.
- Involvement of both palm and back of the hand in contiguity.
- The rash may have an elevated border.
- Nearby nails may also be infected (tinea unguium). However, other skin conditions can also affect nails.
What are the complications of tinea manuum?
- Spread of the fungal infection to other skin sites
- Spread of the fungal infection to others
How is tinea manuum diagnosed?
Tinea manuum is a clinical diagnosis confirmed by microscopy and culture of skin scrapings (see Laboratory tests for fungal infection).
What is the differential diagnosis of tinea manuum?
- Hand dermatitis
- Psoriasis of the hand
- Keratolysis exfoliativa