Tinea manuum: A report of 18 cases observed in the metropolitan area of Milan and review of the literature

Abstract

Summary Objective Tinea manuum is considered in Italy as an uncommon infection, although no recent epidemiological data are available. Methods In the period 2000‐2018, we observed in the metropolitan area of Milan 18 patients with mycologically tinea manuum. Results The infection was monolateral in all patients and characterised by erythema and scaling; in two patients, each vesicles and pustules were present. Two patients had also onychomycosis of one fingernail. No cases of simultaneous tinea pedis were observed. As far as the job of these patients is concerned, seven of them were masseurs, three barbers, two cattlemen, two masons, one car mechanic, one florist, one maid and one veterinarian. Trichophyton rubrum was isolated in 6 patients, Microsporum canis in 4, Trichophyton gypseum in 3, Trichophyton verrucosum in 3 and Trichophyton violaceum in 2 patients. Conclusion Masseurs were the most affected. Trichophyton rubrum and Microsporum canis were the most frequent isolated dermatophytes.

SnapshotDx Quiz: May 2021

“…The three genera in this group (i.e., Trichophyton, Microsporum, and Epidermophyton) subsist on keratin and thus preferentially colonize the hair, the skin, and the nails (Kovitwanichkanont and Chong, 2019). Tinea manus, also referred to as tinea manuum, occurs as a result of dermatophyte infection on the dorsal or palmar aspect of the hand (Ely et al, 2014;Veraldi et al, 2019;Weitzman and Summerbell, 1995). Trichophyton rubrum is the most commonly implicated pathogen (Weitzman and Summerbell, 1995).…”

“…Population-level studies have shown dramatically varying incidence rates, ranging from <2 to 16% (Veraldi et al, 2019) of all dermatophyte infections. When presenting in conjunction with tinea pedis, it is classically referred to as one-hand, two-feet syndrome.…”

“…Several studies have hypothesized that this clinical presentation is a consequence of dermatophyte autoinoculation while excoriating the feet (Daniel et al, 1997). Clinical features suggestive of the diagnosis include unilateral, diffuse hyperkeratosis of the palmar creases and interdigital areas on a background of erythema (Weitzman and Summerbell, 1995), although vesicles and bullae have also been described (Veraldi et al, 2019). Concomitant nail involvement (i.e., onychomycosis) may be characterized by yellowish discoloration, subungual hyperkeratosis, or onycholysis (Kovitwanichkanont and Chong, 2019;Weitzman and Summerbell, 1995).…”