Tinea manuum: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
Line 44: Line 44:


</gallery>
</gallery>
==Differential diagnosis==
Tinea manuum must be differentiated from other diseases that cause ust be differentiated from other diseases that cause rash and eczema such as secondary syphilis and pityriasis rosea.
{| class="wikitable"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Rash Characteristics
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs and Symptoms
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Associated Conditions
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Images
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cutaneous T cell lymphoma]]/[[Mycosis fungoides]]<ref name="urlMycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/lymphoma/patient/mycosis-fungoides-treatment-pdq |title=Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute |format= |work= |accessdate=}}</ref>
|
* '''Premycotic phase:''' A scaly, red [[rash]] in areas of the [[body]] that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years.
* '''Patch phase:''' Thin, [[erythematous]], [[eczema]]-like rash.
* '''[[Plaque]] phase:''' Small raised [[Bumps on skin|bumps]] ([[Papule|papules]]) or hardened [[lesions]] on the skin, which may be [[erythematous]].
* '''[[Tumor]] phase:''' Tumors form on the [[skin]]. [[Infection]] secondary to [[Ulcer|ulcers]].
|
* [[Epidermis (skin)|Epidermal]] [[atrophy]] or poikiloderma
* Generalized [[itching]] ([[pruritus]])
* [[Pain]] in the affected area of the skin
* [[Insomnia]]
* Red ([[erythematous]]) patches scattered over the [[skin]] of the [[trunk]] and the [[extremities]]
* Tumor-like lobulated outgrowths form on the skin in the latter phase of the disease
* [[Weight loss]]
* [[Lymphadenopathy]]
* [[Malaise]] and [[fatigue]]
* [[Anemia]]
* May progress to [[Sezary syndrome]] (skin involvement plus hematogenous dissemination)
|
* [[Sezary syndrome]]
|
[[Image:Mycosis_fungoides.JPG|200px|thumb|By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=7139812]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pityriasis rosea]]<ref name="pmid27512182">{{cite journal |vauthors=Mahajan K, Relhan V, Relhan AK, Garg VK |title=Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects |journal=Indian J Dermatol |volume=61 |issue=4 |pages=375–84 |year=2016 |pmid=27512182 |pmc=4966395 |doi=10.4103/0019-5154.185699 |url=}}</ref>
|
* Pink or salmon in color, which may be scaly; referred to as "herald patch"
* Oval shape
* Long axis oriented along the cleavage lines
* Distributed on the [[trunk]] and [[proximal extremities]]
* Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on  posterior trunk
* Secondary to [[viral infection]]<nowiki/>s
* Resolves spontaneously after 6-8 weeks
|
* Preceded by a prodrome of:
** [[Sore throat]]
** [[Gastrointestinal tract|Gastrointestinal]] disturbance
** [[Fever]]
** [[Arthralgia]]
|
* Infection by any of the following:<ref name="pmid19997691">{{cite journal |vauthors=Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A |title=Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea |journal=Acta Derm. Venereol. |volume=89 |issue=6 |pages=604–6 |year=2009 |pmid=19997691 |doi=10.2340/00015555-0703 |url=}}</ref>
** [[Human herpesvirus 6|HHV-6]]
** [[HHV-7]]
** [[HHV-8]]
|
[[Image:Pityriasisrosea.png|200px|thumb|By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16305230]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pityriasis lichenoides chronica]]
|
* Recurrent [[lesions]] are usually less evenly scattered than in cases of psoriasis
* Brownish red or orange-brown in color
* [[Lesions]] are capped by a single detachable, opaque, mica-like scale
* Often leave [[Hypopigmented area|hypopigmented]] [[Macule|macules]]
|
* High [[fever]]
* [[Malaise]]
* [[Myalgias]]
* [[Paraesthesia]]
* [[Pruritis|Pruritus]]
|
* Infection by any of the following:<ref name="pmid9109005">{{cite journal |vauthors=Smith KJ, Nelson A, Skelton H, Yeager J, Wagner KF |title=Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early stage disease. The Military Medical Consortium for the Advancement of Retroviral Research (MMCARR) |journal=Int. J. Dermatol. |volume=36 |issue=2 |pages=104–9 |year=1997 |pmid=9109005 |doi= |url=}}</ref>
** [[Epstein Barr virus|Epstein-Barr virus]] (EBV)
** ''[[Toxoplasma gondii]]''
** [[Human Immunodeficiency Virus (HIV)|Human immunodeficiency virus]] (HIV)
|
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nummular dermatitis]]<ref name="pmid23517392">{{cite journal |vauthors=Jiamton S, Tangjaturonrusamee C, Kulthanan K |title=Clinical features and aggravating factors in nummular eczema in Thais |journal=Asian Pac. J. Allergy Immunol. |volume=31 |issue=1 |pages=36–42 |year=2013 |pmid=23517392 |doi= |url=}}</ref>
|
* Multiple coin-shaped [[Eczematous Scaling|eczematous]] [[lesions]]
* Commonly affecting the [[extremities]] (lower>upper) and [[trunk]]
* May ooze [[fluid]] and become dry and crusty
|
* Often appears after a skin injury, such as a [[burn]], [[abrasion]] (from friction), or [[insect bite]]
* [[Lesions]] commonly relapse after occasional remission or may persist for long periods
* [[Pruritis|Pruritus]]
|
* Associated with:
** Dry skin
** Emotional stress
** [[Allergens]] (rubber chemicals, [[formaldehyde]], [[neomycin]], chrome, [[Mercury (element)|mercury]], and [[nickel]])
** [[Staphylococcus]] infection
** Seasonal variation
** [[Alcohol]]
** [[Drugs]]
** [[Atopy]]
|
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Secondary syphilis]]<ref name="urlSTD Facts - Syphilis">{{cite web |url=https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm |title=STD Facts - Syphilis |format= |work= |accessdate=}}</ref>
|
* Round, coppery, red colored [[lesions]] on palms and soles
* [[Papule|Papules]] with collarette of scales
|
* [[Fever]]
* [[Lymphadenopathy|Generalized lymphadenopathy]]
* [[Sore throat]]
* [[Hair loss|Patchy hair loss]]
* [[Headaches|Headache]]
* [[Weight loss]]
* [[Myalgia]]
* [[Fatigue]]
|
* Associated with:
** [[Condyloma latum|Condylomata lata]]
** Corona verinata
** Positive [[Venereal disease research laboratory (VDRL) test|VDRL]] test
|
[[Image:Secondary_Syphilis.jpg|200px|thumb|By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16305230]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bowen’s disease]]<ref name="pmid28523295">{{cite journal |vauthors=Neagu TP, Tiglis M, Botezatu D, Enache V, Cobilinschi CO, Vâlcea-Precup MS, GrinTescu IM |title=Clinical, histological and therapeutic features of Bowen's disease |journal=Rom J Morphol Embryol |volume=58 |issue=1 |pages=33–40 |year=2017 |pmid=28523295 |doi= |url=}}</ref>
|
* [[Erythematous]], small, scaly plaque, which enlarges erratically over time
* Scale is usually yellow or white and it is easily detachable without any [[bleeding]]
* Well-defined margins
|
* [[Pruritis|Pruritus]]
* [[Pain]]
* Bleeding [[lesions]]
|
* Associated with:<ref name="pmid25201325">{{cite journal |vauthors=Murao K, Yoshioka R, Kubo Y |title=Human papillomavirus infection in Bowen disease: negative p53 expression, not p16(INK4a) overexpression, is correlated with human papillomavirus-associated Bowen disease |journal=J. Dermatol. |volume=41 |issue=10 |pages=878–84 |year=2014 |pmid=25201325 |doi=10.1111/1346-8138.12613 |url=}}</ref>
** [[Erythroplasia of Queyrat]] ([[Bowen's disease]] of the [[penis]])
** [[Squamous cell carcinoma]]
** Solar radiation and [[ultraviolet]] (UV) exposure
** [[Radiation therapy|Radiotherapy]]
** [[Immunosuppression]]
** [[Arsenic]] exposure
** [[Human papillomavirus|Human papilloma virus]] (HPV) type 16
** [[Polyomavirus|Merkel cell polyomavirus]]
** [[Sjögren's syndrome|Sjögren’s syndrome]]
|
[[Image:Bowen.jpg|200px|thumb|By Klaus D. Peter, Gummersbach, Germany - Own work (own photograph), CC BY 3.0 de, https://commons.wikimedia.org/w/index.php?curid=6839115]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Exanthematous pustulosis]]<ref name="pmid26354880">{{cite journal |vauthors=Szatkowski J, Schwartz RA |title=Acute generalized exanthematous pustulosis (AGEP): A review and update |journal=J. Am. Acad. Dermatol. |volume=73 |issue=5 |pages=843–8 |year=2015 |pmid=26354880 |doi=10.1016/j.jaad.2015.07.017 |url=}}</ref>
|
* Numerous small, primarily non-follicular, sterile [[pustules]], arising within large areas of [[Edema|edematous]] [[erythema]]
|
* [[Fever]]
* [[Leukocytosis]]
* Intracorneal, subcorneal, and/or intraepidermal [[pustules]] with [[papillary]] [[dermal]] [[edema]] containing [[neutrophils]] and [[eosinophils]]
|
* Associated with:<ref name="pmid12466124">{{cite journal |vauthors=Schmid S, Kuechler PC, Britschgi M, Steiner UC, Yawalkar N, Limat A, Baltensperger K, Braathen L, Pichler WJ |title=Acute generalized exanthematous pustulosis: role of cytotoxic T cells in pustule formation |journal=Am. J. Pathol. |volume=161 |issue=6 |pages=2079–86 |year=2002 |pmid=12466124 |pmc=1850901 |doi=10.1016/S0002-9440(10)64486-0 |url=}}</ref>
** [[Antibiotics]] ([[Penicillin|penicillins]], [[sulfonamides]], [[tetracyclines]])
** [[Carbamazepine]]
** [[Calcium channel blocker|Calcium channel blockers]] ([[Diltiazem]])
** [[Hydroxychloroquine]]
|
[[Image:Acute_generalized_exanthematous_pustulosis.jpg|200px|thumb|By See below - (2010). "Acute generalized exanthematous pustulosis: an unusual side effect of meropenem". Indian J Dermatol 55 (2): 176–7. DOI:10.4103/0019-5154.62759. PMID 20606889. PMC: 2887524., CC BY 1.0, https://commons.wikimedia.org/w/index.php?curid=52979729]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lichen planus|Hypertrophic lichen planus]]<ref name="pmid27222766">{{cite journal |vauthors=Ankad BS, Beergouder SL |title=Hypertrophic lichen planus versus prurigo nodularis: a dermoscopic perspective |journal=Dermatol Pract Concept |volume=6 |issue=2 |pages=9–15 |year=2016 |pmid=27222766 |pmc=4866621 |doi=10.5826/dpc.0602a03 |url=}}</ref>
|
* Classically involves shin and ankles and is characterized by [[Hyperkeratosis|hyperkeratotic]] [[Plaque|plaques]] and [[Nodule (medicine)|nodules]] covered by a scale
* [[Lesions]] may transform into [[Hyperkeratosis|hyperkeratotic]] thickened, elevated, purplish or reddish [[Plaque|plaques]] and [[nodules]]
|
* Chronic [[pruritis|pruritus]]
* Scaling
* May be [[asymptomatic]]
|
* Associated with [[Hepatitis C virus]] infection<ref name="pmid19770446">{{cite journal |vauthors=Shengyuan L, Songpo Y, Wen W, Wenjing T, Haitao Z, Binyou W |title=Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis |journal=Arch Dermatol |volume=145 |issue=9 |pages=1040–7 |year=2009 |pmid=19770446 |doi=10.1001/archdermatol.2009.200 |url=}}</ref>
|
[[Image:Lichen_planus2.JPG|200px|thumb|Di James Heilman, MD - Opera propria, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11509003]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Sneddon–Wilkinson disease<ref name="pmid9564592">{{cite journal |vauthors=Lutz ME, Daoud MS, McEvoy MT, Gibson LE |title=Subcorneal pustular dermatosis: a clinical study of ten patients |journal=Cutis |volume=61 |issue=4 |pages=203–8 |year=1998 |pmid=9564592 |doi= |url=}}</ref>
|
* [[Flaccid]] [[pustules]] that are often generalized and have a tendency to involve the flexural areas
* Annular configuration
|
* [[Pruritis|Pruritus]]
* May be asymptomatic
|
* Associated with:
** [[Monoclonal gammopathy]], usually an [[IgA]] paraproteinemia<ref name="pmid3056995">{{cite journal |vauthors=Kasha EE, Epinette WW |title=Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) in association with a monoclonal IgA gammopathy: a report and review of the literature |journal=J. Am. Acad. Dermatol. |volume=19 |issue=5 Pt 1 |pages=854–8 |year=1988 |pmid=3056995 |doi= |url=}}</ref>
** [[Crohn's disease]]<ref name="pmid1357895">{{cite journal |vauthors=Delaporte E, Colombel JF, Nguyen-Mailfer C, Piette F, Cortot A, Bergoend H |title=Subcorneal pustular dermatosis in a patient with Crohn's disease |journal=Acta Derm. Venereol. |volume=72 |issue=4 |pages=301–2 |year=1992 |pmid=1357895 |doi= |url=}}</ref>
** [[Osteomyelitis]]
** [[Adalimumab]]<ref name="pmid23489057">{{cite journal |vauthors=Sauder MB, Glassman SJ |title=Palmoplantar subcorneal pustular dermatosis following adalimumab therapy for rheumatoid arthritis |journal=Int. J. Dermatol. |volume=52 |issue=5 |pages=624–8 |year=2013 |pmid=23489057 |doi=10.1111/j.1365-4632.2012.05707.x |url=}}</ref>
|
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Parapsoriasis|Small plaque parapsoriasis]]<ref name="pmid7026622">{{cite journal |vauthors=Lambert WC, Everett MA |title=The nosology of parapsoriasis |journal=J. Am. Acad. Dermatol. |volume=5 |issue=4 |pages=373–95 |year=1981 |pmid=7026622 |doi= |url=}}</ref>
|
* [[Erythematous]] [[plaques]] with fine scaly surface
* May present with elongated, finger-like patches
* Symmetrical distribution on the flanks
* Known as digitate dermatosis
|
* [[Lesions]] may be [[asymptomatic]]
* May be mildly [[Itch|pruritic]]
* May fade or disappear after sun exposure during the summer season, but typically recur during the winter
|
* May progress to [[mycosis fungoides]]<ref name="pmid16191852">{{cite journal |vauthors=Väkevä L, Sarna S, Vaalasti A, Pukkala E, Kariniemi AL, Ranki A |title=A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides |journal=Acta Derm. Venereol. |volume=85 |issue=4 |pages=318–23 |year=2005 |pmid=16191852 |doi=10.1080/00015550510030087 |url=}}</ref>
|
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Intertrigo]]<ref name="pmid16156342">{{cite journal |vauthors=Janniger CK, Schwartz RA, Szepietowski JC, Reich A |title=Intertrigo and common secondary skin infections |journal=Am Fam Physician |volume=72 |issue=5 |pages=833–8 |year=2005 |pmid=16156342 |doi= |url=}}</ref>
|
* Red and fleshy looking [[lesion]] in [[skin]] folds
* [[Itching]]
* Oozing
* May be sore
|
* [[Pruritis|Pruritus]]
* Musty odor
|
* Associated with:
** [[Infections]] (Fungal, bacterial, viral)
** [[Allergies]]
** [[Diabetes Mellitus|Diabetes]]
** [[Obesity]]
|
[[Image:Axillary_intertrigo.png|200px|thumb|Source: https://www.cdc.gov/]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Langerhans cell histiocytosis]]<ref name="pmid18577030">{{cite journal |vauthors=Satter EK, High WA |title=Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society |journal=Pediatr Dermatol |volume=25 |issue=3 |pages=291–5 |year=2008 |pmid=18577030 |doi=10.1111/j.1525-1470.2008.00669.x |url=}}</ref>
|
* Scaling and crusting of [[scalp]]
|
* Pathological fractures<ref name="pmid1636041">{{cite journal |vauthors=Stull MA, Kransdorf MJ, Devaney KO |title=Langerhans cell histiocytosis of bone |journal=Radiographics |volume=12 |issue=4 |pages=801–23 |year=1992 |pmid=1636041 |doi=10.1148/radiographics.12.4.1636041 |url=}}</ref>
* Visceromegaly ([[hepatomegaly]], [[spleenomegaly]])
* [[Chronic cough, severe cold|Chronic cough]]
* [[Dyspnea]]<ref name="pmid17527085">{{cite journal |vauthors=Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF |title=Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases |journal=Am. J. Surg. Pathol. |volume=31 |issue=6 |pages=947–52 |year=2007 |pmid=17527085 |doi=10.1097/01.pas.0000249443.82971.bb |url=}}</ref>
* [[Lymphadenopathy]]
|
* Associated with:
** [[Diabetes insipidus]]<ref name="pmid16047354">{{cite journal |vauthors=Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, Henter JI, Janka-Schaub G, Ladisch S, Ritter J, Steiner M, Unger E, Gadner H |title=Risk factors for diabetes insipidus in langerhans cell histiocytosis |journal=Pediatr Blood Cancer |volume=46 |issue=2 |pages=228–33 |year=2006 |pmid=16047354 |doi=10.1002/pbc.20425 |url=}}</ref>
** [[Pancytopenia]]
|
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tinea manuum]]/pedum/capitis<ref name="pmid15050029">{{cite journal |vauthors=Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G |title=Dermatology for the practicing allergist: Tinea pedis and its complications |journal=Clin Mol Allergy |volume=2 |issue=1 |pages=5 |year=2004 |pmid=15050029 |pmc=419368 |doi=10.1186/1476-7961-2-5 |url=}}</ref>
|
* Scaling, flaking, and sometimes blistering of the affected areas
* Hair loss with a black dot on scalp in case of [[tinea capitis]]
|
* [[Pruritis|Pruritus]]
* [[KOH]] preparation of the [[lesions]] confirms [[fungal infection]]
|
* Associated with:
** [[Diabetes mellitus|Diabetes]]
** [[Immunosupression]]
** Intimate contact with infected person
** May lead to [[asthma]] exacerbation
|
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Seborrheic dermatitis]]
|
* [[Papulosquamous]], scaly, flaky, [[itchy]], and red [[rash]] found particularly at [[sebaceous gland]]-rich areas of the body
|
* [[Pruritus]]
|
* Associated with:<ref name="pmid16848386">{{cite journal |vauthors=Schwartz RA, Janusz CA, Janniger CK |title=Seborrheic dermatitis: an overview |journal=Am Fam Physician |volume=74 |issue=1 |pages=125–30 |year=2006 |pmid=16848386 |doi= |url=}}</ref>
** [[AIDS]]
** [[Stress]]<ref name="pmid18033062">{{cite journal |vauthors=Misery L, Touboul S, Vinçot C, Dutray S, Rolland-Jacob G, Consoli SG, Farcet Y, Feton-Danou N, Cardinaud F, Callot V, De La Chapelle C, Pomey-Rey D, Consoli SM |title=[Stress and seborrheic dermatitis] |language=French |journal=Ann Dermatol Venereol |volume=134 |issue=11 |pages=833–7 |year=2007 |pmid=18033062 |doi= |url=}}</ref>
** [[Fungal infection]]
** [[Fatigue]]
** [[Sleep deprivation]]
** Change of season
** [[Parkinson's disease|Parkinson's]] disease
** [[Biotin]] deficiency
|
[[Image:Seborrhoeic_dermatitisnew.jpg|thumb|200px|By Roymishali - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=27267929]]
|}


==Treatment==
==Treatment==

Latest revision as of 21:23, 7 September 2017

Tinea manuum
ICD-10 B35.2
ICD-9 110.2

Dermatophytosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Dermatophytosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiographic Findings

X-Ray Findings

CT scan Findings

MRI Findings

Ultrasound Findings

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Tinea manuum On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Tinea manuum

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA onTinea manuum

CDC on Tinea manuum

Tinea manuum in the news

Blogs on Tinea manuum

Directions to Hospitals Treating Dermatophytosis here

Risk calculators and risk factors for Tinea manuum

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Overview

Tinea Manuum is a parasitic fungal infection (mycosis) of the hand in the dermatophytosis (tinea) group. It is typically more aggressive than tinea pedis but similar in look. Itching, burning, cracking, and scaling are observable and may be transmitted sexually or otherwise, whether or not symptoms are present.

Diagnosis

Physical Examination

Skin

Hand

Differential diagnosis

Tinea manuum must be differentiated from other diseases that cause ust be differentiated from other diseases that cause rash and eczema such as secondary syphilis and pityriasis rosea.

Disease Rash Characteristics Signs and Symptoms Associated Conditions Images
Cutaneous T cell lymphoma/Mycosis fungoides[2]
By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=7139812
Pityriasis rosea[3]
  • Pink or salmon in color, which may be scaly; referred to as "herald patch"
  • Oval shape
  • Long axis oriented along the cleavage lines
  • Distributed on the trunk and proximal extremities
  • Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on posterior trunk
  • Secondary to viral infections
  • Resolves spontaneously after 6-8 weeks
By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16305230
Pityriasis lichenoides chronica
  • Recurrent lesions are usually less evenly scattered than in cases of psoriasis
  • Brownish red or orange-brown in color
  • Lesions are capped by a single detachable, opaque, mica-like scale
  • Often leave hypopigmented macules
Nummular dermatitis[6]
  • Lesions commonly relapse after occasional remission or may persist for long periods
  • Pruritus
Secondary syphilis[7]
  • Round, coppery, red colored lesions on palms and soles
  • Papules with collarette of scales
By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16305230
Bowen’s disease[8]
  • Erythematous, small, scaly plaque, which enlarges erratically over time
  • Scale is usually yellow or white and it is easily detachable without any bleeding
  • Well-defined margins
By Klaus D. Peter, Gummersbach, Germany - Own work (own photograph), CC BY 3.0 de, https://commons.wikimedia.org/w/index.php?curid=6839115
Exanthematous pustulosis[10]
By See below - (2010). "Acute generalized exanthematous pustulosis: an unusual side effect of meropenem". Indian J Dermatol 55 (2): 176–7. DOI:10.4103/0019-5154.62759. PMID 20606889. PMC: 2887524., CC BY 1.0, https://commons.wikimedia.org/w/index.php?curid=52979729
Hypertrophic lichen planus[12]
Di James Heilman, MD - Opera propria, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11509003
Sneddon–Wilkinson disease[14]
  • Flaccid pustules that are often generalized and have a tendency to involve the flexural areas
  • Annular configuration
Small plaque parapsoriasis[18]
  • Erythematous plaques with fine scaly surface
  • May present with elongated, finger-like patches
  • Symmetrical distribution on the flanks
  • Known as digitate dermatosis
  • Lesions may be asymptomatic
  • May be mildly pruritic
  • May fade or disappear after sun exposure during the summer season, but typically recur during the winter
Intertrigo[20]
Source: https://www.cdc.gov/
Langerhans cell histiocytosis[21]
  • Scaling and crusting of scalp
Tinea manuum/pedum/capitis[25]
  • Scaling, flaking, and sometimes blistering of the affected areas
  • Hair loss with a black dot on scalp in case of tinea capitis
Seborrheic dermatitis
By Roymishali - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=27267929

Treatment

It can usually be treated with long term use of a topical antifungal cream such as selenium sulfide shampoo. However, in some cases an oral antifungal such as griseofulvin may have to be prescribed.

Template:Mycoses

Template:WH Template:WikiDoc Sources

  1. ↑ 1.0 1.1 1.2 1.3 "Dermatology Atlas".
  2. ↑ "Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute".
  3. ↑ Mahajan K, Relhan V, Relhan AK, Garg VK (2016). "Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects". Indian J Dermatol. 61 (4): 375–84. doi:10.4103/0019-5154.185699. PMC 4966395. PMID 27512182.
  4. ↑ Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A (2009). "Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea". Acta Derm. Venereol. 89 (6): 604–6. doi:10.2340/00015555-0703. PMID 19997691.
  5. ↑ Smith KJ, Nelson A, Skelton H, Yeager J, Wagner KF (1997). "Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early stage disease. The Military Medical Consortium for the Advancement of Retroviral Research (MMCARR)". Int. J. Dermatol. 36 (2): 104–9. PMID 9109005.
  6. ↑ Jiamton S, Tangjaturonrusamee C, Kulthanan K (2013). "Clinical features and aggravating factors in nummular eczema in Thais". Asian Pac. J. Allergy Immunol. 31 (1): 36–42. PMID 23517392.
  7. ↑ "STD Facts - Syphilis".
  8. ↑ Neagu TP, Tiglis M, Botezatu D, Enache V, Cobilinschi CO, Vâlcea-Precup MS, GrinTescu IM (2017). "Clinical, histological and therapeutic features of Bowen's disease". Rom J Morphol Embryol. 58 (1): 33–40. PMID 28523295.
  9. ↑ Murao K, Yoshioka R, Kubo Y (2014). "Human papillomavirus infection in Bowen disease: negative p53 expression, not p16(INK4a) overexpression, is correlated with human papillomavirus-associated Bowen disease". J. Dermatol. 41 (10): 878–84. doi:10.1111/1346-8138.12613. PMID 25201325.
  10. ↑ Szatkowski J, Schwartz RA (2015). "Acute generalized exanthematous pustulosis (AGEP): A review and update". J. Am. Acad. Dermatol. 73 (5): 843–8. doi:10.1016/j.jaad.2015.07.017. PMID 26354880.
  11. ↑ Schmid S, Kuechler PC, Britschgi M, Steiner UC, Yawalkar N, Limat A, Baltensperger K, Braathen L, Pichler WJ (2002). "Acute generalized exanthematous pustulosis: role of cytotoxic T cells in pustule formation". Am. J. Pathol. 161 (6): 2079–86. doi:10.1016/S0002-9440(10)64486-0. PMC 1850901. PMID 12466124.
  12. ↑ Ankad BS, Beergouder SL (2016). "Hypertrophic lichen planus versus prurigo nodularis: a dermoscopic perspective". Dermatol Pract Concept. 6 (2): 9–15. doi:10.5826/dpc.0602a03. PMC 4866621. PMID 27222766.
  13. ↑ Shengyuan L, Songpo Y, Wen W, Wenjing T, Haitao Z, Binyou W (2009). "Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis". Arch Dermatol. 145 (9): 1040–7. doi:10.1001/archdermatol.2009.200. PMID 19770446.
  14. ↑ Lutz ME, Daoud MS, McEvoy MT, Gibson LE (1998). "Subcorneal pustular dermatosis: a clinical study of ten patients". Cutis. 61 (4): 203–8. PMID 9564592.
  15. ↑ Kasha EE, Epinette WW (1988). "Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) in association with a monoclonal IgA gammopathy: a report and review of the literature". J. Am. Acad. Dermatol. 19 (5 Pt 1): 854–8. PMID 3056995.
  16. ↑ Delaporte E, Colombel JF, Nguyen-Mailfer C, Piette F, Cortot A, Bergoend H (1992). "Subcorneal pustular dermatosis in a patient with Crohn's disease". Acta Derm. Venereol. 72 (4): 301–2. PMID 1357895.
  17. ↑ Sauder MB, Glassman SJ (2013). "Palmoplantar subcorneal pustular dermatosis following adalimumab therapy for rheumatoid arthritis". Int. J. Dermatol. 52 (5): 624–8. doi:10.1111/j.1365-4632.2012.05707.x. PMID 23489057.
  18. ↑ Lambert WC, Everett MA (1981). "The nosology of parapsoriasis". J. Am. Acad. Dermatol. 5 (4): 373–95. PMID 7026622.
  19. ↑ Väkevä L, Sarna S, Vaalasti A, Pukkala E, Kariniemi AL, Ranki A (2005). "A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides". Acta Derm. Venereol. 85 (4): 318–23. doi:10.1080/00015550510030087. PMID 16191852.
  20. ↑ Janniger CK, Schwartz RA, Szepietowski JC, Reich A (2005). "Intertrigo and common secondary skin infections". Am Fam Physician. 72 (5): 833–8. PMID 16156342.
  21. ↑ Satter EK, High WA (2008). "Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society". Pediatr Dermatol. 25 (3): 291–5. doi:10.1111/j.1525-1470.2008.00669.x. PMID 18577030.
  22. ↑ Stull MA, Kransdorf MJ, Devaney KO (1992). "Langerhans cell histiocytosis of bone". Radiographics. 12 (4): 801–23. doi:10.1148/radiographics.12.4.1636041. PMID 1636041.
  23. ↑ Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF (2007). "Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases". Am. J. Surg. Pathol. 31 (6): 947–52. doi:10.1097/01.pas.0000249443.82971.bb. PMID 17527085.
  24. ↑ Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, Henter JI, Janka-Schaub G, Ladisch S, Ritter J, Steiner M, Unger E, Gadner H (2006). "Risk factors for diabetes insipidus in langerhans cell histiocytosis". Pediatr Blood Cancer. 46 (2): 228–33. doi:10.1002/pbc.20425. PMID 16047354.
  25. ↑ Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G (2004). "Dermatology for the practicing allergist: Tinea pedis and its complications". Clin Mol Allergy. 2 (1): 5. doi:10.1186/1476-7961-2-5. PMC 419368. PMID 15050029.
  26. ↑ Schwartz RA, Janusz CA, Janniger CK (2006). "Seborrheic dermatitis: an overview". Am Fam Physician. 74 (1): 125–30. PMID 16848386.
  27. ↑ Misery L, Touboul S, Vinçot C, Dutray S, Rolland-Jacob G, Consoli SG, Farcet Y, Feton-Danou N, Cardinaud F, Callot V, De La Chapelle C, Pomey-Rey D, Consoli SM (2007). "[Stress and seborrheic dermatitis]". Ann Dermatol Venereol (in French). 134 (11): 833–7. PMID 18033062.
Retrieved from "https://www.wikidoc.org/index.php?title=Tinea_manuum&oldid=1349989"