Tinea manuum and tinea pedis


Tinea manuum and tinea pedis

Description, Causes and Risk Factors:

Description and Causes:

Dermatophytosis is caused by fungi in the genera Microsporum (A genus of fungus of the family Moniliaceae; causes ringworm), Trichophyton (A genus of fungus of the family Moniliaceae; causes ringworm and favus), and Epidermophyton (A genus of fungi, separated from Trichophyton on the basis that it never invades the hair follicles, whose macroconidia are clavate and smooth walled. The only species, Epidermophyton floccosum, is an anthropophilic species that is a common cause of tinea pedis and tinea cruris).

Dermatophytes are the pathogenic members of the keratinophilic (keratin digesting) soil fungi. Microsporum and Trichophyton are human and animal pathogens. Epidermophyton is a human pathogen.

Tinea manuum: Dermatophytosis of the hand, usually referring to infections of the palmar surface. This is a complication actually occurs in hands but is a rare disease as compare to tinea pedis. This disease actually targets both sexes and at any age group. However, children are more prone to tinea manuum.

The cause is likely of zoophilic or geophilic fungus such as:

    Trichophyton erinacei - from a hedgehog.

  • T. verrucosum - from cattle.

  • Microsporum canis - from a cat or dog.

  • M. gypseum - from soil.

In some cases T. rubrum, T. mentagrophytes var. interdigitale, and Epidermophyton floccosum may also include.

The disease can spread.

    Contact with another site of infection, particular feet (tinea pedis) and groin (tinea cruris).

  • Contact with another person with tinea or an infected animal (mostly cats) or soil.

  • Contact with contaminated object such as towel or gardening tools.

Symptoms:

    The most common symptom is formation of scabrous rashes either on the palms or between the fingers of an infected person.

  • The rash may be usually itching, stinging, or burning.

  • The rash is not painful.

  • It can also cause the skin to be wet and "weepy."

  • The rashes are slightly lifted in the edges resemble healthy skin in their middle.

  • In most cases on single hand is involved.

Diagnosis:

Differential diagnosis may include:

    Hand dermatitis - especially the type called pompholyx.

  • Psoriasis - especially palmoplantar pustulosis.

  • Keratolysis exfoliativa.

The doctor will easily comprehend that an individual is suffering from tinea manuum by looking at the rough rashes and by inquiring about its associated symptoms. A sometimes a sample of rashes would be taken out through scraping to study deeply about the cause of the disease. A culture of rash may also be taken to confirm the fungal infection and indentify the type of fungus.

Treatment:

It takes at least a fortnight or a month to completely cure an infected person. The disease is not serious, hence can be treated through topical application of antifungal cream. Topical antifungal agents such as butenafine (Mentax), econazole (Spectazole) and terbinafine (Lamisil AT) may be effective, but oral medications are more reliable because the skin is much thicker on the palms of the hands and topicals may not penetrate as well. Alternative therapies include terbinafine (Lamisil), itraconazole (Sporanox) or fluconazole (Diflucan).

Patients should be reevaluated 6 months after treatment as there is a significant recurrence rate with tinea manuum.

Preventive measures may include:

    Good skin hygiene.

  • Good nail hygiene.

  • Avoiding prolonged wetting or dampness of skin and feet.

Tinea Pedis:

Alternative Name: Athlete's foot, ringworm of foot, dermatomycosis pedis.

Tinea Pedis: Dermatophytosis of the feet, especially of the skin between the toes, caused by one of the dermatophytes, usually a species of Trichophyton or Epidermophyton.

There are three forms of tinea pedis:

    Interdigital - Macerated, scaly, fissured skin occurs between the toes, especially in the web space between the 4th and 5th toes.

  • Plantar (“moccasin foot”) - Fine, powdery scale is present on a reddened background of the sole, heel, and sides of the foot.

  • Vesicular (bullous) - An acute inflammatory reaction consisting of vesicles and pustules.

Tinea pedis is the most common. It may occur at the same time as other fungal skin infections such as ringworm or jock itch. These fungi thrive in warm, moist areas.

Tinea pedis is most frequently due to:

    Trichophyton rubrum.

  • T. interdigitale, previously called T. mentagrophytes var. interdigitale.

  • Epidermophyton floccosum.

Tinea pedis is contagious and spread through direct contact with people or objects such as showers, shoes, socks, locker rooms, or pool surfaces. Pets can carry the fungus and may also be a source of transmission.

Risk Factors may include:

    Are a man.

  • Have a weakened immune system.

  • Frequently wear damp socks or tightfitting shoes.

  • Share mats, rugs, bed linens, clothes or shoes with someone who has a fungal infection.

  • Walk barefoot in public areas where the infection can spread, such as locker rooms, saunas, swimming pools, communal baths and showers.

Symptoms:

    Cracked, flaking, peeling skin between the toes.

  • The affected area is usually red and itchy.

  • You may feel burning or stinging, and there may be blisters, oozing, or crusting.

  • Excessive dryness of the skin on the bottoms or sides of the feet.

  • Toenails that are thick, crumbly, ragged, discolored or pulling away from the nail bed.

Diagnosis:

The diagnosis of tinea pedis is usually madeclinically and based upon the examination of theaffected area. Definitive diagnosis may be madeby scraping the skin for a KOH preparation, a skinbiopsy, or culture of the affected skin.

The KOHpreparation is less likely to be positive in severecases with maceration of the skin. Your doctor may take skin scrapings or samples from the infected area and view them under a microscope. If a sample shows fungi, treatment may include an antifungal medication. If the test is negative, your doctor may examine the area with a Wood's lamp (black light) to see if there is a reddish fluorescence caused by erythrasma bacteria. If both tests are negative, a sample may be sent to a lab to determine whether it will grow fungi under the right conditions.

Treatment:

Over-the-counter antifungal powders or creams can help control the mild infection. These generally contain miconazole, clotrimazole, or tolnaftate. Continue using the medicine for 1 - 2 weeks after the infection has cleared from your feet to prevent the infection from returning.

If the infections is severe or doesn't respond to over-the-counter medicine, you may need a prescription-strength topical or oral medication.

    Topical medications: These include clotrimazole and miconazole.

  • Oral medications: These include itraconazole (Sporanox), fluconazole (Diflucan) and terbinafine (Lamisil). Side effects from oral medications include gastrointestinal upset, rash and abnormal liver function. Taking other medications, such as antacid therapies for ulcer disease or gastroesophageal reflux disease (GERD), may interfere with the absorption of these drugs. Oral medications for tinea pedis may alter the effectiveness of warfarin, an anticoagulant drug that decreases the clotting ability of your blood.

  • Your doctor may prescribe an oral antibiotic if you have an accompanying bacterial infection. In addition, your doctor may recommend wet dressings, steroid ointments, compresses or vinegar soaks to help clear up blisters or soggy skin.

Preventive Measures:

    Keeping the feet clean and dry is one of the best methods of prevention.

  • A well-ventilated shoes that fit properly and are not tight.

  • Alternating shoes daily will allow shoes to dry thoroughly in between wearing.

  • Socks should be dry and changed frequently. Wool socks draw moisture away from feet and are highly recommended.

  • Wearing sandals or flip-flops in public showers or pool areas may also help prevent tinea pedis.

  • Nails should be clipped short and kept clean.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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