Tinea manuum

Mycosis of the hand.

Mainly adults are affected. Patients like to infect themselves from tinea pedum or nail mycosis.

• Exciter
  • Trichophyton rubrum (large majority)
  • Trichophyton mentagrophytes (approx. 10%)
  • Epidermophyton floccosum (approx. 4%)
  • Microsporum canis
  • Microsporum gypseum
• Mostly transmission occurs through fungal infections at other localisations

• The backs of the hands and fingers, the interdigital space and the palms may be affected. Mostly erythematous, scaly, ggl. hyperkeratotic-rhagadiform plaques are seen
• An association exists with tinea barbae

• Clinic
• Detection of pathogens (epilation of hair or collection of dandruff: then native preparation and culture; biopsy)

Mostly only on one hand, can become bilateral.

• If zoophilic dermatophytes are detected, all animals with which contact has occurred should be examined
• Investigate other people in the household
• Therapy should be carried out with both topical and systemic antifungal agents!

Topical therapy

• Clotrimazole cream
• Terbinafine cream
• Ketoconazole cream
• Amorolfin cream
• Econazole cream
• Ciclopirox cream

Systemic therapy

• Itraconazole p.o. 200 mg 1x tgl.
• Alternatively: fluconazole p.o. 50 mg 1x tgl.
• Alternatively: Terbinafine p.o. 250 mg 1x tgl.
• Children: Although only griseofulvin is approved in children, we rather recommend the use of itraconazole
with regard to the data situation

1. Lachapelle JM, De Doncker P, Tennstedt D, Cauwenbergh G, Janssen PA. Itraconazole compared with griseofulvin in the treatment of tinea corporis/cruris and tinea pedis/manus: an interpretation of the clinical results of all completed double-blind studies with respect to the pharmacokinetic profile. Dermatology 1992;184:45-50. 
2. Bourlond A, Lachapelle JM, Aussems J, et al. Double-blind comparison of itraconazole with griseofulvin in the treatment of tinea corporis and tinea cruris. Int J Dermatol 1989;28:410-2.