bubble_chart Overview

A fungal infection of the skin occurring between the fingers, toes, and on the palms and soles is called tinea manuum or tinea pedis, commonly known as "goose-web wind" or "athlete's foot." The thick stratum corneum of the palms and soles is prone to friction injury, facilitating the invasion and proliferation of dermatophytes. Therefore, tinea manuum and tinea pedis have a high incidence rate and are stubborn to treat, with Trichophyton rubrum being the primary pathogenic fungus.

bubble_chart Diagnosis

Clinical manifestations 1. Symptoms are milder in winter and more severe in summer, with subjective cutaneous pruritus; 2. Clinically divided into three types: (1) Macerated type: The skin between fingers or toes becomes macerated and whitish, with the epidermis peeling off to reveal red erosions, which are prone to secondary infections; (2) Chickenpox type: Often presents as pinhead-sized chickenpox-like lesions, sometimes coalescing into large blisters; (3) Scale hyperkeratotic type: Mainly characterized by desquamation and thickening, with clear boundaries and occasional chickenpox-like lesions.

Diagnostic criteria 1. Symptoms are milder in winter and more severe in summer; 2. Based on rash characteristics, clinically classified into macerated type, chickenpox type, and scale hyperkeratotic type; 3. Direct microscopic examination of scales reveals hyphae, and fungal culture is positive.

bubble_chart Treatment Measures

Treatment Principles 1. For secondary infections, control the infection first; 2. Select the correct antifungal dosage form based on clinical classification; 3. Systemic antifungal medication may be administered when necessary.

Medication Principles 1. For patients with concurrent bacterial infections, use antibiotics to control the infection before applying antifungal agents; 2. Generally, topical therapy is the main approach, with the correct dosage form selected according to the clinical type: (1) Macerated type: powder or cream; (2) Chickenpox type: solution, tincture, or cream; (3) Scale keratosis type: cream or ointment. 3. For refractory infections, systemic antifungal drugs may be administered, with Sporanox or Lamisil currently being the most commonly used.

bubble_chart Cure Criteria

1. Cure: Skin lesions subside, fungal direct microscopy and culture are negative once a week for 2 consecutive times; 2. Improvement: Partial subsidence of skin lesions, fungal examination negative or positive; 3. No cure: No improvement in skin lesions, fungal examination positive.