Tinea manuum

Last Updated: 2021-10-15

Author(s): -

Tinea manus.

Mainly adults are affected. Patients tend to infect themselves with a tinea pedum or nail mycosis. 

  • Pathogen
    • Trichophyton rubrum (large majority)
    • Trichophyton mentagrophytes (about 10%)
    • Epidermophyton floccosum (about 4%)
    • Microsporum canis
    • Microsporum gypseum
  • In most cases the transmission is caused by fungal infections at other locations
  • The back of the hands and fingers, the interdigital space and the palms of the hands can be affected. Usually erythematous, scaly, hyperkeratotic-rhagadiform plaques appear.
  • There is an association with the Tinea barbae. 
  • Clinical features
  • Pathogen detection (hair removal or dandruff extraction: then native preparation and culture; biopsy)

Usually only on one hand, can be on both sides.

  • If zoophilic dermatophytes are detected, all animals with which contact has existed should be examined.
  • Examination of other people in the household.
  • The therapy should be carried out with both topical and systemic antifungals!

 

Topical Therapy

  • Clotrimazole cream

  • Terbinafine cream 

  • Ketoconazole cream

  • Amorolfin Cream

  • Econazole Cream

  • Ciclopirox cream

 

Systemic Therapy

  • Itraconazole p.o. 200 mg 1x daily 

  • Alternatively: Fluconazole p.o. 50 mg 1x daily

  • Alternatively: Terbinafine p.o. 250 mg 1x daily

  • Children: Although only Griseofulvin is approved for children, we rather recommend the use of Itraconazole
      

  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.