Introduction:
Tinea, also known as ringworm, is a contagious skin infection caused by fungi. Tinea infections refer to a group of diseases caused by fungi. These infections are non-serious, but they can make people uncomfortable. Different names exist for tinea infections that affect the other body parts. These include tinea capitis (scalp), tinea faciei (face), tinea cruris or jock itch (groin), and tinea pedis or Athlete's foot (feet). Tinea infections manifest as red, scaly, ring-shaped patches with clearing centers and can occur on the scalp, arms, legs, face, and trunk. However, infections on the feet, nails, and genital areas are not commonly known as ringworm as they may not appear in the typical ring pattern.
What Is Tinea Manuum?
Tinea manuum (ringworm of the hand) is a prevalent fungal infection that targets the skin on the hands. It is caused by a group of fungi called dermatophytes, which thrive in warm and moist environments. Although not a critical condition, tinea manuum can cause discomfort and affect the appearance of the affected area. This condition is geographically distributed worldwide. It is less common than tinea pedis. It usually occurs in one hand, but may occur in both hands also. Tinea infection is present in one hand and feet together in most cases.
What Are the Causes of the Tinea Manuum?
Tinea manuum is caused by a group of fungi called dermatophytes. Trichophyton rubrum is the most common agent causing this condition across the world. Other dermatophytes reported in various locations include Trichophyton mentagrophytes, Trichophyton verrucosum, Trichophyton interdigitale, Epidermophyton floccosum, and Microsporum canis. These fungi are commonly found in tropical environments.
These fungi thrive in warm and moist environments and can be found on many surfaces, including floors, clothing, and towels. The infection can be contracted through direct contact with an infected person, animal, or soil or by touching contaminated objects or surfaces.
What Are the Risk Factors for Developing the Tinea Manuum?
The risk factors for tinea manuum include:
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Male gender.
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Individuals with hyperhidrosis (heavy sweating).
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People with weakened immune systems.
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People with medical conditions like diabetes or hypertension.
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Obese people.
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Pet owners and farm workers.
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Recurrent work-related trauma to hands, such as individuals who are employed in chemical-related occupations, mechanics.
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People who engage in contact sports like wrestling.
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People who use public locker rooms, and swimming pools.
What Are the Symptoms of Tinea Manuum?
Symptoms appear on one or both hands. The symptoms of tinea manuum can vary from person to person, but they typically include the following:
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Red, scaly patches on palms, fingers, and backs of the hands. Mild itching may be present.
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Raised patches with clear edges.
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A blistering rash may be present on the finger edges or the palm of the affected hand. It may develop in crops, and it is filled with sticky clear fluid.
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Dryness or area of peeling present on the hands.
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Pain and swelling are present in some cases.
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Skin discoloration may be present if the rash persists for a longer time.
What Are the Other Similar Skin Conditions Affecting Hands?
Distinguishing tinea manuum from other skin conditions that affect the hands is crucial to ensure that individuals receive the appropriate treatment. Consulting with a medical professional helps in accurate diagnosis. However, identifying certain unique features may aid the patient in differentiating it from other similar conditions.
Among the conditions that can be mistaken for tinea manuum are hand dermatitis, psoriasis, and exfoliative keratolysis.
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Hand Dermatitis: It typically affects both hands, in contrast to tinea manuum, which may only impact one hand. Additionally, hand dermatitis lacks the raised ring that is a typical sign of tinea manuum and is often itchier.
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Psoriasis: This condition manifests as raised, red patches that may be silvery and lack the characteristic ring of tinea manuum. While tinea manuum can spread if left untreated, psoriasis is less likely to do so.
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Exfoliative Keratolysis: It is a skin condition that affects the palms of the hands and is characterized by peeling blisters, but it does not appear as a ring-like rash.
How Can Tinea Manuum Be Diagnosed?
Tinea manuum can usually be diagnosed with the physical examination of the affected area. The healthcare professional may examine the back of the hand, fingers, and palms. They will look for symptoms such as red, scaly, and itchy patches on the palms, fingers, and backs of the hands, raised patches with clear edges, blisters or bumps, dryness, and peeling area if any.
A skin scraping may be taken from the affected area to be examined under a microscope in some cases. This can help confirm the presence of the dermatophyte fungi that cause tinea manuum. Tests to confirm the diagnosis include:
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KOH (Potassium Hydroxide) Stain: The doctor will remove some skin from the affected hand area. The lab technician will place the sample on a microscope slide containing a drop of potassium hydroxide (KOH). Using KOH stain, the technician can easily examine the sample under the microscope to determine the presence of any fungi. Typically, the results of the test can be obtained within a day.
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Culture: In cases where the KOH stain fails to provide proper results, the doctor may go for culture. A culture is a medium that facilitates the growth of fungi, enabling the technician to identify the fungus responsible for the infection. At the same time, culture is more reliable and specific than a KOH stain. It typically takes several weeks to generate results.
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Dermatoscopy: This useful tool consists of a handheld instrument equipped with a magnifying lens and lighting system to see details that are not detectable to the naked eye. If someone has a tinea manuum, the dermoscopy may reveal white scales in the cracks of palms.
What Is the Treatment for Tinea Manuum?
Tinea manuum infection can be quite persistent and may take several weeks or months to clear up completely. The treatment of tinea manuum typically involves the use of antifungal medications, which include:
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Topical Antifungal Medications: The first line of treatment for tinea manuum is usually topical antifungal medications, which are applied directly to the affected area. These medications include creams, ointments, and lotions containing antifungal agents such as Terbinafine, Clotrimazole, Miconazole, or Econazole. Topical medications are generally effective for mild to moderate cases of tinea manuum, and the treatment course typically lasts for 2 to 4 weeks.
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Oral Antifungal Medications: If the infection is severe or does not respond to topical treatments, oral antifungal medications may be prescribed. These medications include Terbinafine, Itraconazole, and Fluconazole, and they work by targeting the fungus from within the body. Oral antifungal medications may need to be taken for several weeks.
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Treating Coexisting Conditions: People with tinea manuum may also have other conditions contributing to the infection. Treating these underlying conditions can help to improve the effectiveness of antifungal treatments.
Conclusion:
Tinea manuum is a commonly occurring skin infection among people. The best way to prevent tinea manuum is to practice good hygiene. This includes washing hands frequently, keeping the hands clean and dry, and avoiding touching contaminated surfaces. It is also important to avoid sharing personal items such as towels or clothing and to wear gloves when handling wet objects. It is important to follow the treatment plan prescribed by a healthcare professional and to continue treatment even if the symptoms improve.
