Tinea manus

(Tinea manus)

Aetiology and pathogenesis

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

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: the 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 , goosefoot madness , pathology overview: tinea cruris is a dermatophyte infection of the palm of the hand. If only the dorsum of the hand is involved, ring-shaped or multi-ring-shaped damage, it is still called tinea corporis. Tinea cruris is widely prevalent throughout the world and has 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 applicator, compound rezacin applicator and so on.

Keratinized thickened type can be compound benzoic acid ointment, miconazole cream or 10% glacial acetic acid soak. There are chapped people, can be added with urea fat, etc.. After the lesions subside, you 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 Mildew 250mg/day for 2 weeks. Prevention Ringworm of the nails and tinea cruris are sources of infection for each other and should be treated simultaneously, including ringworm of other parts of the body. Avoid scratching and hot water. Less contact with various detergents, soaps and organic solvents. Clinical manifestations There are two types: blisters and scales type: the onset of the disease is mostly a single case, starting with a certain part of the palm of the hand, especially the center of the palm, the palm surface of the finger and ring finger, the side and the 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 or multiple ring-shaped damage, with clear margins, a chronic course, and a duration of many years, until it involves all the palms of the hands and spreads to the dorsum of the hands and nails, and even the opposite palms of the hands. 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 palms of the hands in addition to dermatophytes, but also with long-term scratching, washing and scalding, soap, detergent, a variety of chemicals and solvents stimulation and inappropriate treatment related to the?

Diagnosis Starting from a certain part of the palm of the hand, slowly expanding, and eventually involving most, all or even both palms, the damage is erythema, blisters, scales and thickening of keratinization, the diagnosis of tinea cruris should be considered, and the diagnosis can be confirmed by a positive mycological examination. Differential diagnosis Complications Etiology Tinea cruris mostly comes from scratching tinea pedis, tinea cruris and tinea capitis, etc. direct contact infection or the spread of onychomycosis and tinea cruris on the back of the hand. The causative agent of tinea cruris is 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.

Is itchy, peeling hands necessarily ringworm?

Tinea cruris, commonly known as tinea cruris, is caused by a fungal infection. With ringworm, you will often feel itchy, and the skin on your hands will also appear pimples, blisters, erythema 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 becomes rough, dry and thickened, and can 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 palms of the hands, and both hands are symmetrical. The lesions are polymorphic, and papules, blisters, vesicles, ooze and scabs can be seen at the same time, often with two to three of them as the main ones. The change of the disease is closely related to the seasons, and there is also some correlation with diet and rest. Damage can be exacerbated if the palms of the hands come into contact with irritants such as water and soap. Fungal tests are negative.

Sweat herpes occurs with obvious seasonality, most of the onset in the spring and summer, into the winter since the cure, mainly 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 and hot seasons. The lesions mainly involve the hearts of the hands and feet, bilateral symmetry, manifested as the formation of small white spots of keratolysis and easy to peel off the thin paper-like scales, the skin underneath is normal, itching is not obvious. Fungal examination is negative.