Do you have ringworm on your hands? Most of them are caused by scratching

Reviewer: Zhang Shuyuan, Chief Physician, Beijing Huayi Integrated Traditional Chinese and Western Medicine Dermatology Hospital

In life, we often encounter such situations: when we feel itchy, we always want to scratch it with our hands; when we are cleaning at home, after washing clothes or food, some small blisters appear on our hands, some on the fingertips, some on the palms, they don’t hurt or itch, but they look unpleasant, so we just squeeze them.

Little do people know that these seemingly normal scratching and squeezing may lead to fungal infection and cause tinea manuum.

1. Why do you get tinea manuum?

According to traditional Chinese medicine, the skin ringworm disease with the main symptoms of blisters, desquamation, roughness, thickening, dryness, cracking, pain and itching on the palms, which is called tinea manuum in modern medicine, is caused by fungal infection.

So, why do we get tinea manuum? This is related to personal living habits and physical constitution.

Some people do not pay attention to personal hygiene and suffer from skin ringworm in other parts of the body. They often scratch and scratch, which can easily spread to the hands and cause ringworm of the hand.

Figure 1 Copyright image, no permission to reprint

Patients with eczema and psoriasis have low immunity and reduced ability to resist fungal infections.

The skin barrier of people whose skin is damaged or whose skin is stimulated by acidic and alkaline substances for a long time is destroyed, making it easy for fungi to invade.

2. Diagnosis and treatment of tinea manuum

Tinea manuum is contagious, so early detection, early diagnosis and early treatment are extremely important for controlling the disease and improving symptoms.

So, how to diagnose and treat tinea manuum?

First of all, the goal of treatment is to eliminate pathogens, quickly relieve symptoms, and prevent recurrence. Medically, topical medications, oral medications, or a combination of the two can be used.

1. Topical medication treatment

If tinea manuum is mild or in the early stages, it can be treated with topical medication.

At present, topical antifungal drugs include: ① Imidazoles, including miconazole, ketoconazole, econazole, clotrimazole, bifonazole and luliconazole, etc. ② Allylamines, mainly including terbinafine, butenafine and naftifine, etc. ③ Others, such as amorolfine of the morpholine class, ciclopirox olamine of the pyrrolone class, and liranapthate of the thiocarbamate class.

The advantages of using topical antifungal drugs to treat tinea manuum are rapid onset of action, low cost, and few systemic adverse reactions. Generally, a sufficient course of treatment will cure the disease. The disadvantage is that the course of treatment is relatively long, and some patients cannot persist in applying the drugs on time, which will affect the treatment effect. Some patients choose an inappropriate dosage form of topical drugs, which leads to local adverse reactions, poor efficacy, and repeated attacks of tinea manuum [1].

2. Taking oral medication

Oral antifungal drugs can effectively treat tinea manuum. Its advantages are short course of treatment, convenient medication, no missed lesions, high patient compliance, and low recurrence rate. This method is generally suitable for people with large affected areas, poor local treatment effects, and recurrent tinea manuum.

Commonly used oral antifungal drugs include itraconazole and terbinafine. It should be noted that although these two oral drugs have been proven to be safe and effective in numerous clinical studies, their specific use still needs to be carried out under the guidance of a doctor to ensure safety and efficacy [1].

3. Combination drug therapy

For patients with complex conditions, a combination regimen can be used to improve efficacy and shorten the course of treatment.

A common method is to use a topical medication in combination with an oral medication; it is also possible to choose to use two topical medications with different antifungal mechanisms in combination [1].

3. Prevention and treatment measures for tinea manuum

Tinea manuum brings inconvenience and trouble to patients' lives, and is prone to recurrence. Therefore, it is very important to prevent tinea manuum. Specific preventive measures include:

1. Pay attention to your diet

Try to avoid eating spicy and irritating foods, do not smoke or drink, and eat more fresh vegetables and fruits to improve your body's immunity.

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2. Avoid infection

Patients with tinea manuum should regularly disinfect their clothes and daily necessities to avoid infecting other family members; in daily life, they should pay attention to personal hygiene, take a bath frequently, and keep the affected area clean and dry.

3. Treat and prevent tinea pedis

90% of tinea manuum is transmitted from one's own tinea pedis. Therefore, patients with tinea pedis must take good treatment and prevention measures to prevent the infection from spreading to their hands.

In addition to maintaining good personal hygiene and regularly disinfecting personal belongings by sterilizing and boiling them, you should also avoid or not wear rubber shoes and hiking shoes with poor breathability. Wash and dry them in time after wearing to eliminate any remaining fungi in your shoes and socks and avoid affecting your hands.

In short, tinea manuum is caused by fungal diseases in other parts of the body. Therefore, you should try to avoid scratching or scratching fungal infection lesions on your body, otherwise inadvertent scratching will bring the risk of tinea manuum to your hands, so it is particularly important to take good precautions.

References

[1] Chinese Tinea Manuum and Tinea Pedis Diagnosis and Treatment Guidelines Working Group. Chinese Tinea Manuum and Tinea Pedis Diagnosis and Treatment Guidelines (Popular Science Edition 2022). Chinese Journal of Mycology, 2022, 17(2): 89-93.