For years, a 39-year-old man had an eruption on his hand, which seemed to becontrolled with topical corticosteroids. The patient was a rancher.
For years, a 39-year-old man had an eruption on his hand, which seemed to becontrolled with topical corticosteroids. The patient was a rancher.The lesion's well-defined annular, scaly border raised suspicion of tineamanuum, which was confirmed by a potassium hydroxide evaluation. His occupationsuggested that livestock were the likely source of the infection. Chronichand eczema and psoriasis had also been considered in the differential. Thepatient's use of corticosteroids had exacerbated the infection and made it moredifficult to diagnose and treat.A 2-week course of oral terbinafine, 250 mg/d, plus a topical imidazole usedfor 1 month resolved the infection.