Description of the problem:

A flaky skin condition on the fingers that sometimes cracks and bleeds.

Ans:

Tinea manus

(Tinea manus)

Etiology and pathogenesis

Chinese medicine is called goose paws, the causative fungus is the same as tinea pedis, with Trichophyton rubrum.

Clinical manifestations

Mostly from a part of the hand, especially the thumb or index finger side, flexion surface and palm, and then gradually expand. The typology is the same as tinea pedis. But because the palm of the hand is exposed, help rarely see the interphalangeal maceration vesicles. However, Candida albicans caused by the interphalangeal vesicles can be seen. Papulosquamous type often has small blisters, durable with ring-like scales. The blistering type has significant itching, and is prone to secondary infections if it occurs on the palms and proximal fingers. Hyperkeratosis type palm and finger obvious keratinization, often with wrinkles and cracks.

Treatment

Same as tinea pedis.

Prevention

In addition to active treatment of tinea cruris, combined with tinea pedis, tinea corporis and tinea cruris, should be treated at the same time.

Tinea cruris alias tinea pedis Pathology Overview

Tinea cruris is a dermatophyte infection of the palm of the hand. If only the dorsum of the hand is involved, and ring-shaped or multi-ring-shaped damage occurs, it is still called tinea corporis. Tinea cruris is widely prevalent throughout the world, with a high incidence in China. Long-term immersion of hands in water and friction injuries and contact with detergents, solvents, etc. is an important cause of tinea infection. Patients are mostly young and middle-aged women, many of whom have a history of wearing rings. Epidemiologic features Pathogenesis Treatment

Blistering scaly type can be used externally with miconazole cream, clotrimazole cream, compound benzoic acid application, compound lei locksing application and so on. Keratinized thickening type can be compound benzoic acid ointment, miconazole cream or 10% glacial acetic acid soak. For those with cracks, urea lipids can be added. After the lesions subside, they should continue to apply the medicine for at least 2 weeks. The frequency of hand application should be appropriately increased, especially after washing hands with ointment or cream. If the disease duration is long or the effect of topical treatment is poor, the patient can take oral ashwagandha, ketoconazole, etc. or fluconazole 50%mg. Or fluconazole 50%mg/day or 150mg/week at once, for 2-4 weeks. Itraconazole 200mg/day at once for one week. Therapeutic mold Xu 250mg / day, taken for 2 weeks. Prevention

Tinea cruris and tinea cruris are mutually infectious and should be treated at the same time, including tinea cruris in other parts of the body. Try to avoid scratching and hot water. Less contact with various detergents, soaps and organic solvents. Clinical manifestations

There are two types: blisters scaly type: the onset of the disease is mostly a single case, starting with a part of the palm of the hand, especially the palm, the palm of the finger and ring finger palm surface, side and root. They begin as pinhead-sized blisters with thick, shiny walls containing clear fluid. The blisters are clustered or sparsely distributed and are itchy. The blisters dry up, flake off and gradually spread to the surrounding area to form a ring-shaped or multi-ring-shaped damage, with clear margins, chronic course, lasting for many years, until it involves all the palms and spreads to the backs of the hands and nails, and even the opposite palms. Sometimes the blisters can be infected to form pustules. Keratinization thickening type: mostly developed from blisters scaly type, patients have a history of many years, often has been involved in both hands, the lesions are not obvious blisters or ring shaped flaking, palm surface diffuse redness and thickening, deepening of dermatoglyphic lines, the skin is rough, dry and there is a flaking, easy to crack in the winter, the fissure is deep and there is bleeding, the pain is intolerable, and it affects the activities. Factors contributing to the thickening of keratinization of the palm in addition to dermatophytes, but also with long-term scratching, washing and scalding, soaps, detergents, a variety of chemicals and solvents *** as well as inappropriate treatment. Diagnosis

Starting from a certain part of the palm, slowly expanding, and eventually involving most, all or even both palms, the damage is erythema, blisters, scales and keratotic thickening, the diagnosis of tinea versicolor should be considered, and the diagnosis can be confirmed by a positive mycological examination. Differential diagnosis

Complications

Causes

Tinea versicolor is mostly from scratching tinea pedis, tinea cruris and tinea capitis, etc., direct contact infection or the spread of onychomycosis and tinea versicolor on the back of the hand. The pathogenic bacteria of tinea versicolor are mainly Trichophyton rubrum, accounting for about 55.6%, followed by Trichophyton mentagrophytes, accounting for about 22.7%. Candida albicans can also cause the same damage as ringworm.

Does itching and peeling of the hands necessarily mean ringworm?

Ringworm, commonly known as tinea cruris, is caused by a fungal infection. Tinea versicolor is often itchy, and the skin on the hands will appear pimples, blisters, red spots and flaking. It starts out as small patches, and then the damage gradually expands and becomes well defined. Over time, the skin on the hands will become rough, dry and thickened, and can also be accompanied by cracking and bleeding. But if there are symptoms such as itchy hands and peeling skin, can we say that it must be ringworm? Of course not, there are many skin diseases can be seen itchy hands, peeling skin symptoms, such as eczema, sweating herpes, contact dermatitis, exfoliative keratolysis, etc., should be carefully identified, otherwise it will delay the diagnosis and treatment.

Eczema mostly occurs in the palm of the hand, and both hands symmetrical. The lesions are polymorphic, visible papules, blisters, vesicles, ooze and scabs, etc. exist simultaneously, often two to three of them are dominant. The change of the disease is closely related to the seasons, and there is also some correlation with diet and rest. Damage is exacerbated if the palms of the hands come into contact with water and soap, etc ***. Fungal examination is negative.

The occurrence of sweating herpes has obvious seasonality, most of the onset of spring and summer, into the winter since the healing, mainly seen in young people. The lesions are also symmetrically distributed, mainly blisters, in batches of episodes, can be seen on the palm surface of the hand, the side of the finger and the end of the finger, the blisters dry and peel off, revealing the new skin, often accompanied by varying degrees of itchiness and burning sensation. This disease occurs with poor sweating or allergic reaction has a certain relationship, the damage at the fungal examination is negative.

Contact dermatitis is caused by contact with allergy-inducing substances, and is an allergic reaction of the skin with a clear history of contact. Skin lesions occur in the contact area, the boundary is clear, the shape is more consistent, mostly erythema, edema, severe cases can be seen blisters, blisters, etc.. After removing the contact material, the lesions can gradually subside and heal. Local fungal examination is negative.

Exfoliative keratolysis is a superficial exfoliative dermatosis of the palmoplantar area, often accompanied by localized sweating, and easy to flare up during the warm season. The lesions mainly involve the hearts of the hands and feet, bilateral symmetry, manifested as the formation of keratolysis of small white spots and easy to peel off the thin paper-like scales, the skin underneath is normal, itching is not obvious. Fungal examination is negative.

Can you cook with tinea versicolor?

As we know, tinea cruris is caused by fungi, so it has a certain degree of contagious. Especially in the development stage of tinea versicolor, the rash is very active, appearing red spots, papules, blisters and flaking lesions, at this time the fungus grows and reproduces very quickly, and the infectiousness is also strong. Because at any time there can be fungi spread out with the dander, if the sick hand is used to touch the food, the food will also be contaminated. However, the contagion of tinea versicolor is mainly through direct contact such as shaking hands, rather than through food. And most of the food should be steamed after high temperature before eating, the fungus has long been eliminated, will not jeopardize the health of people.

So, with tinea versicolor, you can still go to the kitchen? Generally speaking, even if the ringworm patients in the kitchen cooking will not lead to infection; and cause ringworm fungi will not lead to visceral diseases. However, in order to ensure the health of the consumer, people with tinea versicolor are not allowed to work in the kitchen.

So what do people who do housework at home, such as housewives, do when they have tinea cruris? First of all, it should be treated immediately. If the moment failed to cure, do some housework is no harm, but before cooking should try to wash the hand, and it is best not to suffer from tinea versicolor hand contact with cold food, so as to reduce the chance of fungal contamination of food, to ensure that the food is clean and hygienic.

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