Tinea Manus is the ringworm of the hands, fingers, nails or palms. In general, Tinea is the name given to a dermatophyte or fungus that is capable of growing on skin, nails and hair. It grows out and spreads in the form of a circle leaving behind normal looking skin in the center. This gives the infection a ‘ring’ like appearance. The edge of the ring, which is itchy, raised and scaly often looks like a worm crawling under the skin. In the past, people actually believed there was a worm under the infected portion, hence the name ‘ringworm’ came to be used for this infection.
In reality: ringworm infections are caused by a zoophilic (animal based) or anthropophilic (human based) dermatophytes or fungi. Ringworm of the hands is referred to by many other names like tinea mannum, Tine manus, or hand dermatophytosis. Three kinds of dermatophytes are responsible for causing it: Trichophyton, Microsporum or Epidermophyton.
Symptoms and Diagnosis of Tinea Manus
Ringworm of the hands is characterized by following signs and symptoms:
- In ringworm of the nails, there is thickening of nails starting at the finger tips
- The nail bed becomes invaded and appears creamy or yellow in color.
- Chalk colored patches might also be seen on the nails. These are caused by Trichophyton mentagrophytes fungus.
- Inter-digital Tinea Manus is characterized by softening of the skin in between the fingers. There is inflammation and itchiness in this region.
- Eczema like reaction might be seen on the hands. This includes skin thickening, red brown scaly rashes, and blisters that are inflamed and extremely itchy.
Diagnosis of Tinea Manus is confirmed by microscopic evaluation of the culture of skin on the hands and palms as well as that beneath the nails or sample of nail clippings etc. The collected material is then examined under a microscope using Potassium hydroxide preparation. This helps reveal the type of dermatophyte causing the infection.
What causes ringworm of the hands?
Ringworm of the hands is usually predominant in hot, humid or tropical areas. It is also seen frequently on wrestlers, athletes and other contact sportspersons. The Fungi require warm, moist and humid conditions to grow and thrive. Hence, it is seen in locker rooms, showering cubicles, swimming facilities, tanning beds, etc. Sharing sporting goods, towels and clothing can spread the ringworm infection.
People most susceptible to Tinea Manus are:
- Those with suppressed immunity
- Athletes and wrestlers or other contact sports people
- Family members of people having the infection
- Those who are genetically predisposed to it.
- Pet owners with pets having fungal skin infections
Prevention and Treatment
Anti-parasitic medication or ointments containing sulfur, mercury or iodine are the best known treatments for ringworm of the hands. Prescription anti-sweat medicines can also help prevent sweat in patients who are required to wear gloves for sports or work for long periods of time.
Along with anti-fungal preparations, topical corticosteroid may be advised for fungal eczema. If the fungal culture reveals that the infection is caused by animal fungus, then the advice of a veterinarian expert is urged. For nail fungal infections, Ciclopirox Nail Lacquer is recommended to treat superficial infections. In some severe cases, oral anti fugal medicines may also be prescribed for effective therapy. All treatment should be followed as advised and not stopped when there is slight improvement. Failure to do so will cause the infection to return. Topical skin creams are typically advised to be used daily for a period of 2 weeks for positive results.
Prevention is also the best measure in these cases. Some preventive steps include:
- Avoid sharing of towels, sporting equipments etc.
- Wash clothes and gloves on highest heat settings, preferably with mild bleach or anti microbial detergents.
- People who are prone to these infections should minimize their exposure by avoiding places like public shower rooms, sports lockers etc. If contact is suspected, hands should be thoroughly washed with anti bacterial and anti fungal soaps.
- Pets with fungal skin infections should be treated and isolated if needed. Children should be taught to wash hands after petting infected animals. As far as possible, avoid touching pets having bald spots on their fur.
Tinea Manus is not as common as Tinea Pedis or ringworm of the feet, however, it is still an aggressive infection that can cause discomfort so care should be taken to minimize and prevent its spread to other people.