Tinea manus (known in the plural form as tinea manuum) is a superficial dermatophyte infection involving one or both hands. In most cases, a single hand is involved; when both hands are affected, the involvement is generally asymmetric. Tinea manus may be associated with two feet-one hand syndrome, in which the locations of infectious involvement correspond with its name. Tinea infections are more common postpuberty, and men are more often affected than women. Lower socioeconomic status is also a risk factor. There does not appear to be a difference in prevalence between ethnicities.

The etiology is frequently related to autoinoculation (ie, contact with a separate site of infection such as the foot or groin) or contact with an infected individual, animal, soil, or object (eg, an infected towel). Due to the frequency of autoinoculation, causative organisms are often similar to those involved in tinea pedis and tinea cruris: Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum. Two nondermatophyte fungi that can lead to a similar clinical picture are Scytalidium dimidiatum and Scytalidium hyalinum.

Signs and symptoms can include scaling of involved skin and pruritus; painful fissuring and maceration can occur, especially if there is interdigital involvement. Morphology often differs based on location. Infection of the palm often appears as a thin, white, scaly accentuation of the palmar creases with fine, powdery surrounding scale, whereas dorsal hand involvement appears similar to tinea infections elsewhere on the body, as an annular or serpiginous scaly plaque with leading edge and central clearing. This difference in appearance is thought to be related to the lack of sebaceous glands on the palms. Clinical variants include interdigital, hyperkeratotic (most frequently seen on the palmar surfaces), exfoliative, papular, and vesiculobullous forms.

Rarely, a dermatophytid reaction (autoeczematization, or id reaction) may occur in association with tinea manuum; this is a form of hypersensitivity that can be seen in relation to a distal superficial dermatophyte infection. It generally appears as a symmetric, generalized pruritic eruption and can be associated with constitutional symptoms.

Immunocompromised Patient Considerations
Generally, tinea infections may be more severe and chronic / recurrent in immunosuppressed patients, such as those with human immunodeficiency virus (HIV) disease or common variable immunodeficiency syndrome.

Related topic: Tinea corporis