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Tinea Manuum

Disease Details

Family Health Simplified

Description
Tinea manuum is a fungal infection affecting the skin of the hands, typically causing redness, scaling, and itching.
Type
Tinea manuum is a type of fungal infection affecting the hands. It is not a genetic condition and therefore has no genetic transmission. The infection is transmitted through direct contact with the fungus, commonly through touching contaminated surfaces or infected individuals.
Signs And Symptoms
There is usually an itch, with generalised dry flaky thick skin of the palm of a hand. Frequently, one hand is affected, but it can be in both. If the back of the hand is affected, it may appear as reddish circles like in ringworm. Sometimes there are no symptoms. The feet may be affected as in two feet-one hand syndrome.
Prognosis
Tinea manuum is a fungal infection affecting the hands. The prognosis is generally good with appropriate treatment, which includes topical or oral antifungal medications. Early diagnosis and adherence to prescribed therapies typically result in complete resolution of the infection. However, if left untreated, it can become chronic and more difficult to eradicate. Preventive measures, such as practicing good hand hygiene and avoiding contact with infected individuals or contaminated objects, are essential to prevent recurrence.
Onset
Tinea manuum is a fungal infection (dermatophytosis) of the hands. The onset is usually gradual, with symptoms developing over weeks to months. It often starts with itching, redness, and scaling on the palms or the back of the hands, and may become chronic if not treated.
Prevalence
The prevalence of tinea manuum, a fungal infection of the hands caused by dermatophytes, is generally low compared to other forms of tinea infections. It is relatively rare and is more often seen in individuals who have occupations involving manual labor or in those with immunocompromised conditions. The exact prevalence can vary by region and population.
Epidemiology
Tinea manuum is most common in young adult males. Dermatophyte infections occur in up to a quarter of the world's population, of which the hands and feet are most commonly involved. It occurs worldwide. One large study revealed around 84% of tinea manuum was associated with athlete's foot, of which 80% admitted scratching their feet, and 60% were male,
Intractability
Tinea manuum is not typically considered intractable. It is usually treatable with appropriate antifungal medications, including topical treatments for mild cases and oral medications for more severe or widespread infections. Proper hygiene and preventative measures can also help manage and prevent recurrence.
Disease Severity
The severity of tinea manuum can vary. It usually presents as a mild condition with symptoms such as dry, scaly, and itchy skin on the hands. However, in more severe cases, it can cause intense itching, redness, and even blisters.
Healthcare Professionals
Disease Ontology ID - DOID:13369
Pathophysiology
Tinea manuum is a fungal infection of the hands, primarily caused by dermatophytes such as Trichophyton rubrum and Trichophyton mentagrophytes. The pathophysiology involves the fungi invading the stratum corneum of the epidermis. This invasion elicits an inflammatory response where keratinases and other enzymes produced by the fungi digest keratin, allowing the fungus to sustain itself in the skin.

The infection often manifests as well-demarcated erythematous plaques, scaling, and sometimes vesicles or pustules, particularly on the palmar surfaces of the hands. It can spread through direct contact with an infected person, animal, or contaminated object. Effective treatment typically involves the use of topical or systemic antifungal medications.
Carrier Status
Tinea manuum does not typically involve a carrier status in the same sense as some infectious diseases. It is a fungal infection caused by dermatophytes, most commonly Trichophyton species. These fungi can be transmitted through direct contact with an infected person or animal, or indirectly through contact with contaminated objects or surfaces. The term "carrier" is not generally applicable as it is with bacterial or viral infections where individuals may harbor the pathogen without showing symptoms. Instead, tinea manuum is an active infection that presents with symptoms such as redness, scaling, and itching on the hands.
Mechanism
Tinea manuum is a dermatophyte infection of the hands, primarily caused by fungi in the genera Trichophyton, Microsporum, and Epidermophyton. Understanding its mechanism and molecular mechanisms involves several key points:

**Mechanism:**
1. **Transmission:** Tinea manuum spreads through direct contact with infected individuals, animals, or contaminated surfaces and objects.
2. **Colonization:** The dermatophyte fungi colonize the stratum corneum layer of the epidermis, which is composed of dead keratinized cells.
3. **Invasion:** The fungi produce enzymes like keratinases, lipases, and proteases, which break down keratin and enable the fungi to invade and utilize keratin as a nutrient source.
4. **Immune Response:** The body's immune system responds to the fungal invasion, leading to inflammation, scaling, and itching as symptoms.

**Molecular Mechanisms:**
1. **Adhesion:** Dermatophyte fungi express specific adhesins that allow them to adhere to keratinocytes in the skin. This is the initial step in colonization.
2. **Keratin Degradation:** The production of keratinases by the fungi is crucial for breaking down keratin in the stratum corneum. These enzymes hydrolyze keratin into smaller peptides and amino acids that the fungi can absorb.
3. **Immune Modulation:** Dermatophytes may produce molecules that modulate the host immune response. They can induce the production of certain cytokines that lead to inflammation, but they may also have mechanisms to evade or suppress immune detection.
4. **Gene Expression:** Various genes in the dermatophytes are upregulated during infection, including those coding for proteins involved in adhesion, nutrition acquisition, and stress responses.

Understanding these mechanisms is essential for developing targeted treatments and preventive strategies against tinea manuum.
Treatment
Treatment is usually with long-term topical antifungal medications. If not resolving, terbinafine or itraconazole by mouth might be options. Other options include clotrimazole, fluconazole and ketoconazole.
Compassionate Use Treatment
Tinea manuum, a fungal infection of the hands, typically requires antifungal treatments. While there are no specific "compassionate use" treatments for tinea manuum, off-label or experimental treatments may include:

1. **Oral Antifungals**: Medications like terbinafine, itraconazole, and fluconazole, though primarily indicated for other types of fungal infections, may be used off-label for tinea manuum when topical treatments fail or the infection is extensive.

2. **Topical Antifungals**: Newer formulations or combination treatments that are not specifically labeled for tinea manuum may be utilized. Examples include topical antifungals such as efinaconazole or luliconazole, which are commonly used for onychomycosis (nail fungal infections).

3. **Phototherapy**: Though not standard, phototherapy using ultraviolet light has been considered in some experimental contexts for treating dermatophyte infections including tinea manuum.

Always consult a healthcare provider for tailored medical advice and treatment plans.
Lifestyle Recommendations
For tinea manuum, here are some lifestyle recommendations to prevent and manage the condition:

1. **Maintain Hand Hygiene**: Wash your hands regularly with soap and water. Dry them thoroughly, especially after washing, as fungi thrive in moist environments.

2. **Avoid Sharing Personal Items**: Do not share towels, gloves, or other personal items that may come into contact with your hands.

3. **Use Antifungal Creams**: Apply over-the-counter antifungal creams as recommended by a healthcare provider to affected areas.

4. **Keep Hands Dry**: Wear gloves when doing wet work like washing dishes to keep hands dry. Consider using powder to reduce moisture in gloves.

5. **Avoid Tight Gloves**: Wear breathable gloves made of natural materials, and avoid tight-fitting gloves that may increase sweating.

6. **Change Gloves and Socks Regularly**: If you wear gloves frequently or perspire heavily, change them regularly to keep your hands dry.

7. **Boost Immune Health**: Maintain a balanced diet, get regular exercise, and manage stress to support your immune system.

8. **Limit Exposure to Infectious Sources**: Be cautious in communal areas like gyms and locker rooms. Wear flip-flops in these areas to reduce the risk of fungal infections spreading to your hands from your feet.

By following these lifestyle recommendations, you can help prevent or manage tinea manuum effectively.
Medication
For tinea manuum, antifungal medications are typically prescribed. These can include topical treatments like terbinafine or clotrimazole, or oral medications such as itraconazole or terbinafine for more severe cases. It's important to follow the prescribed treatment regimen and maintain good hand hygiene to prevent the spread and recurrence of the infection.
Repurposable Drugs
Repurposable drugs for tinea manuum include:

1. **Terbinafine**: Commonly used for tinea infections, including onychomycosis; available in oral and topical forms.
2. **Itraconazole**: Often used for various fungal infections; effective in oral form.
3. **Fluconazole**: Another antifungal that can be repurposed for tinea infections; available in oral form.
4. **Griseofulvin**: Traditionally used for dermatophyte infections; available as an oral medication.
5. **Clotrimazole**: A topical antifungal that can also be used for tinea infections.

These drugs are not initially designed specifically for tinea manuum but have proven effective in treating dermatophyte infections, including tinea manuum.
Metabolites
For tinea manuum, a fungal infection affecting the hands, there are no specific metabolites exclusively associated with the condition. The disease is caused primarily by dermatophytes, such as Trichophyton and Epidermophyton species. The fungi produce general metabolic byproducts during infection, but these aren't unique markers for tinea manuum specifically. The focus for diagnosis and treatment is typically on clinical symptoms and identification of the causative organism through culture or microscopic examination.
Nutraceuticals
Nutraceuticals are food-derived products that provide health benefits, including the prevention and treatment of diseases. For tinea manuum, which is a fungal infection of the hand, specific nutraceuticals have not been widely studied or recommended. However, certain general nutraceuticals may support immune function and overall skin health, potentially aiding recovery alongside conventional treatments.

Examples include:
1. Probiotics: These support gut health and may boost the immune system.
2. Vitamin C: Helps with immune function and skin health.
3. Vitamin E: Known for its skin-healing properties.
4. Omega-3 fatty acids: Help to reduce inflammation and support skin health.

Always consult a healthcare provider before starting any new supplement regimen.
Peptides
Tinea manuum is a fungal infection of the hands. Currently, peptides are not directly utilized in the standard treatment of this condition. The primary treatments involve topical and systemic antifungal medications.