Tinea Types: Common Dermatophyte Infections Case 4 Tinea Manuum and Tinea Unguium

For about 4 months, a very dry, diffuse,fine scaly, asymptomatic eruptioncovered the palms of a 28-yearoldman; several fingernails weredystrophic bilaterally as well. Beforethe onset of this condition, bilateralonychomycosis of the toenails hadbeen diagnosed. The toenails had notbeen treated and were still affectedat the time of presentation. Branchinghyphae were seen on a potassiumhydroxide preparation of a fingernailcutting. The patient had tinea manuumand tinea unguium.The presentation of tinea manuumis similar to that of tinea corporis.Both conditions typically arise as aflat, scaly lesion that eventually manifestsa raised, rounded border. Theborder gradually enlarges, with clearingof the center, and may develop red papules or vesicles.Central areas become brown or hypopigmented and mayhave large papules. The lesion can be as small as a centimeterin diameter or cover large areas. Manifestations oftinea of the palm are similar to those of tinea of the sole;a dry, keratotic appearance may result from heavy manuallabor.Often, tinea manuum and tinea pedis coexist. In suchcases, usually 1 foot and 2 hands or 2 feet and 1 hand areinvolved.A 3-month course of oral terbinafine eradicated thispatient's hand and nail infections.