The infection caused by dermatophytes invading the smooth skin of the palms and between the fingers (toes) is called tinea manuum.

bubble_chart Etiology

The main pathogenic fungi are Trichophyton and Epidermophyton, with common species including Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum. Among these, Trichophyton rubrum has become the primary pathogen of tinea manuum and tinea pedis in China due to its strong resistance and difficulty in control.

This disease is transmitted through contact with {|###|}pestilence{|###|}. Activities such as bathing in public baths, wearing shared slippers, using footwear, socks, gloves of infected individuals, or sharing public towels can easily lead to infection. The widespread prevalence of this disease may be attributed to the fact that Trichophyton rubrum or Epidermophyton floccosum often form arthrospores in skin scales, which can survive harsh environments for extended periods and possess the ability to {|###|}pestilence{|###|} others. Additionally, Trichophyton rubrum tends to cause thickening of the stratum corneum and invade vellus hair, making it difficult to cure and prone to recurrence. Furthermore, because the severity of the lesions is often mild, many patients experience no noticeable symptoms and tend to neglect the condition, delaying medical attention, which often results in prolonged and unresolved infections.

bubble_chart Clinical Manifestations

The clinical manifestations of tinea manuum are generally similar to those of tinea pedis, but the classification is less distinct than in tinea pedis. Initially, the lesions often present with scattered small blisters, followed primarily by desquamation, deepened skin lines, and a rough texture upon touch. Chronic cases may show hyperkeratosis and thickening. A clear boundary is often visible between the affected area and normal skin. The lesions are usually limited to one side, typically starting in the palm, the second, third, or fourth finger, and may eventually involve the entire palm over time. Subjective symptoms are mostly mild or absent.

1. For vesicular type, compound benzoic acid liniment, compound resorcinol liniment, 1-3% econazole, miconazole, clotrimazole or ketoconazole cream can be selected as appropriate, applied topically 2-3 times daily. Sometimes 10% glacial acetic acid soaking therapy may be used.
2. For macerated erosive type, generally milder or lower concentration topical antifungal preparations are selected, such as compound resorcinol liniment or the aforementioned imidazole antifungal creams. Sometimes drying powders like foot powder need to be added.
3. For hyperkeratotic type, antifungal ointments or creams are generally preferred, such as compound benzoic acid ointment, imidazole creams or other antifungal medications.

bubble_chart Differentiation

The diagnosis is not difficult based on typical clinical manifestations. However, atypical tinea manuum and pedis is often easily confused with hand and foot eczema, palmoplantar pustulosis, and pompholyx, among others. Careful differentiation is necessary, and fungal examination often helps clarify the diagnosis.