Tinea manuum is a fungal infection of the hand that is caused by dermatophyte fungi. It is similar to other types of tinea infections, such as tinea pedis (athlete’s foot) and tinea corporis (ringworm) but occurs specifically on the hand.
Tinea manuum can affect one or both hands and is more common in people who have frequent contact with contaminated surfaces or objects, such as athletes, healthcare workers, and people who work with animals.
Epidemiology
The epidemiology of tinea manuum is not well documented in the medical literature, but it is generally considered to be a relatively uncommon condition. The incidence and prevalence of tinea manuum may vary depending on factors such as age, gender, occupation, and geographic location. Tinea manuum is more commonly seen in adults than children, and it appears to be more common in women than men.
People who work in occupations that involve frequent contact with contaminated surfaces or objects, such as athletes, healthcare workers, and people who work with animals, may be at increased risk for developing tinea manuum. Geographic location may also play a role in the prevalence of tinea manuum, as some regions have a higher incidence of fungal infections due to environmental factors such as temperature, humidity, and exposure to fungi.
For example, tinea manuum may be more common in warm, humid climates or in areas with poor sanitation or hygiene. Overall, the exact epidemiology of tinea manuum is not well established, and more research is needed to understand the prevalence and incidence of this condition in different populations.
Anatomy
Pathophysiology
Tinea manuum is a fungal infection caused by dermatophyte fungi. These fungi are known for their ability to grow and thrive in warm, moist environments, such as those found on the hands. The pathophysiology of tinea manuum involves the invasion of the fungal spores into the skin of the hands, where they grow and multiply.
The infection can occur through direct contact with contaminated objects or surfaces, such as towels, clothing, or gym equipment, or through contact with an infected person. Once the fungi have entered the skin, they begin to produce enzymes that break down the keratin proteins in the skin. This process leads to the characteristic symptoms of tinea manuum, including redness, scaling, and itching of the affected area. The rash may be dry or moist and may develop blisters or pustules in severe cases.
In some cases, tinea manuum can spread to other areas of the body, such as the feet, groin, or scalp, causing additional symptoms and complications. Fungal nail infections may also occur as a result of tinea manuum. The pathophysiology of tinea manuum can be effectively treated with antifungal medications that target the underlying fungal infection. Topical or oral antifungal medications are typically used to eliminate the fungi and prevent the infection from spreading to other areas of the body.
Etiology
The etiology of tinea manuum is a fungal infection caused by dermatophyte fungi. These fungi are known for their ability to grow and thrive in warm, moist environments, such as those found on the hands. The most common dermatophyte fungi responsible for tinea manuum are Trichophyton rubrum and Trichophyton mentagrophytes.
These fungi can be found in various environments, such as locker rooms, public showers, and other communal spaces. Direct contact with infected surfaces, objects, or persons can lead to the transmission of these fungi to the hands.
Factors that increase the risk of tinea manuum include:
Frequent hand washing or exposure to water.
Sweaty hands or gloves.
Compromised immune system.
Occupation that involves frequent contact with contaminated surfaces or objects, such as healthcare workers, athletes, and people who work with animals.
Diabetes or other medical conditions that affect circulation or the immune system.
Tinea manuum can also develop as a result of a pre-existing fungal infection in another part of the body, such as the feet or groin. In these cases, the infection can spread to the hands through contact with the affected area. Overall, the etiology of tinea manuum is a fungal infection caused by dermatophyte fungi, which can be transmitted through direct contact with contaminated surfaces, objects, or persons.
Genetics
Prognostic Factors
The prognosis for tinea manuum is generally good with appropriate treatment. Most cases of tinea manuum can be effectively treated with topical or oral antifungal medications, and symptoms usually resolve within several weeks to months. However, recurrence of the infection is possible, especially if the underlying conditions that contributed to the infection are not addressed.
Patients with tinea manuum should follow their healthcare provider’s recommended treatment plan and maintain good hygiene practices to prevent recurrence. In rare cases, tinea manuum can lead to complications such as secondary bacterial infection, but these are generally uncommon.
Clinical History
Clinical history
The clinical history of a patient with tinea manuum typically includes:
Itching: The affected person may experience itching on one or both hands.
Scaling: The skin on the hands may become dry, scaly, and flaky.
Redness: The skin on the hands may become red and inflamed.
Rash: The affected person may develop a rash on the hands that may be raised and have a circular shape.
Pain: Some people may experience pain on their hands due to the fungal infection.
Previous fungal infection: The affected person may have a history of other fungal infections, such as tinea pedis (athlete’s foot).
Exposure to fungi: The person may have had recent exposure to fungi in moist or warm environments, such as locker rooms or swimming pools.
Immunocompromised status: People with weakened immune systems, such as those with HIV or who are undergoing chemotherapy, may be more susceptible to fungal infections, including tinea manuum.
Poor hygiene: People who do not practice good hygiene, such as washing their hands regularly, may be more prone to developing fungal infections on their hands.
Contact with infected individuals: The person may have had contact with someone who has a fungal infection, increasing their risk of developing tinea manuum.
Physical Examination
Physical examination
During the physical examination of a patient suspected of having tinea manuum, the healthcare provider may perform the following:
Inspection of the affected area: The provider will examine the hands to check for signs of a fungal infection, including redness, scaling, flaking, and a circular rash.
Palpation of the affected area: The provider may gently press on the affected area to check for tenderness or pain, which may indicate a more severe infection.
Examination of the nails: The provider may also examine the fingernails to check for signs of a fungal infection, such as thickening, discoloration, or separation from the nail bed.
Scraping of skin samples: The provider may use a scalpel or a blade to scrape off a small sample of skin from the affected area. The sample will be examined under a microscope to confirm the diagnosis of tinea manuum.
Wood’s lamp examination: A Wood’s lamp emits ultraviolet light that can help to identify certain types of fungal infections. The provider may use a Wood’s lamp to examine the affected area and look for any fluorescence, which may indicate the presence of a fungal infection.
Differential diagnosis: The provider may also consider other conditions that can cause similar symptoms, such as eczema, psoriasis, or contact dermatitis.
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Differential diagnosis
The differential diagnosis of tinea manuum includes several conditions that can cause similar symptoms. Some of these conditions are:
Psoriasis: Psoriasis can cause scaly, red, and itchy patches on the hands that may resemble tinea manuum.
Contact dermatitis: Exposure to irritants or allergens can cause a rash on the hands that may be similar to tinea manuum.
Eczema: Eczema can cause red, dry, and itchy patches on the hands that may be mistaken for tinea manuum.
Dyshidrotic eczema: Dyshidrotic eczema is a type of eczema that specifically affects the hands and feet. It can cause small blisters on the hands that may resemble tinea manuum.
Pityriasis rosea: Pityriasis rosea is a viral infection that can cause a rash on the trunk, arms, and legs. It may also affect the hands and cause symptoms similar to tinea manuum.
Scabies: Scabies is a parasitic infection that can cause intense itching and a rash on the hands and other parts of the body.
Systemic lupus erythematosus (SLE): SLE is an autoimmune disorder that can cause a rash on the hands and other parts of the body, as well as joint pain, fatigue, and other symptoms.
These are just a few of the conditions that can cause symptoms similar to tinea manuum. A healthcare provider will consider a patient’s medical history, physical examination, and laboratory tests to make an accurate diagnosis.
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
The treatment of tinea manuum typically involves topical or oral antifungal medications, as well as measures to prevent the spread of the infection. The specific treatment approach may depend on the severity of the infection and the underlying cause. Here are some treatment options:
Topical antifungal medications: Creams, ointments, or lotions containing antifungal agents such as clotrimazole, miconazole, or terbinafine can be applied directly to the affected area.
Oral antifungal medications: In more severe cases of tinea manuum or when topical treatments are not effective, oral antifungal medications such as terbinafine, itraconazole, or fluconazole may be prescribed.
Good hygiene: Patients with tinea manuum should maintain good hygiene practices, including frequent hand washing and avoiding sharing of personal items such as towels or clothing.
Avoiding irritants: Patients should avoid exposure to irritants that can worsen the infection, such as harsh soaps or chemicals.
Addressing underlying conditions: If the tinea manuum infection is associated with an underlying condition, such as a weakened immune system or diabetes, the underlying condition should be treated.
It is important to note that treatment for tinea manuum may take several weeks to be effective, and patients should continue treatment as directed by their healthcare provider to ensure complete resolution of the infection.
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References
https://www.ncbi.nlm.nih.gov/books/NBK559048/
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Tinea manuum is a fungal infection of the hand that is caused by dermatophyte fungi. It is similar to other types of tinea infections, such as tinea pedis (athlete’s foot) and tinea corporis (ringworm) but occurs specifically on the hand.
Tinea manuum can affect one or both hands and is more common in people who have frequent contact with contaminated surfaces or objects, such as athletes, healthcare workers, and people who work with animals.
The epidemiology of tinea manuum is not well documented in the medical literature, but it is generally considered to be a relatively uncommon condition. The incidence and prevalence of tinea manuum may vary depending on factors such as age, gender, occupation, and geographic location. Tinea manuum is more commonly seen in adults than children, and it appears to be more common in women than men.
People who work in occupations that involve frequent contact with contaminated surfaces or objects, such as athletes, healthcare workers, and people who work with animals, may be at increased risk for developing tinea manuum. Geographic location may also play a role in the prevalence of tinea manuum, as some regions have a higher incidence of fungal infections due to environmental factors such as temperature, humidity, and exposure to fungi.
For example, tinea manuum may be more common in warm, humid climates or in areas with poor sanitation or hygiene. Overall, the exact epidemiology of tinea manuum is not well established, and more research is needed to understand the prevalence and incidence of this condition in different populations.
Tinea manuum is a fungal infection caused by dermatophyte fungi. These fungi are known for their ability to grow and thrive in warm, moist environments, such as those found on the hands. The pathophysiology of tinea manuum involves the invasion of the fungal spores into the skin of the hands, where they grow and multiply.
The infection can occur through direct contact with contaminated objects or surfaces, such as towels, clothing, or gym equipment, or through contact with an infected person. Once the fungi have entered the skin, they begin to produce enzymes that break down the keratin proteins in the skin. This process leads to the characteristic symptoms of tinea manuum, including redness, scaling, and itching of the affected area. The rash may be dry or moist and may develop blisters or pustules in severe cases.
In some cases, tinea manuum can spread to other areas of the body, such as the feet, groin, or scalp, causing additional symptoms and complications. Fungal nail infections may also occur as a result of tinea manuum. The pathophysiology of tinea manuum can be effectively treated with antifungal medications that target the underlying fungal infection. Topical or oral antifungal medications are typically used to eliminate the fungi and prevent the infection from spreading to other areas of the body.
The etiology of tinea manuum is a fungal infection caused by dermatophyte fungi. These fungi are known for their ability to grow and thrive in warm, moist environments, such as those found on the hands. The most common dermatophyte fungi responsible for tinea manuum are Trichophyton rubrum and Trichophyton mentagrophytes.
These fungi can be found in various environments, such as locker rooms, public showers, and other communal spaces. Direct contact with infected surfaces, objects, or persons can lead to the transmission of these fungi to the hands.
Factors that increase the risk of tinea manuum include:
Frequent hand washing or exposure to water.
Sweaty hands or gloves.
Compromised immune system.
Occupation that involves frequent contact with contaminated surfaces or objects, such as healthcare workers, athletes, and people who work with animals.
Diabetes or other medical conditions that affect circulation or the immune system.
Tinea manuum can also develop as a result of a pre-existing fungal infection in another part of the body, such as the feet or groin. In these cases, the infection can spread to the hands through contact with the affected area. Overall, the etiology of tinea manuum is a fungal infection caused by dermatophyte fungi, which can be transmitted through direct contact with contaminated surfaces, objects, or persons.
The prognosis for tinea manuum is generally good with appropriate treatment. Most cases of tinea manuum can be effectively treated with topical or oral antifungal medications, and symptoms usually resolve within several weeks to months. However, recurrence of the infection is possible, especially if the underlying conditions that contributed to the infection are not addressed.
Patients with tinea manuum should follow their healthcare provider’s recommended treatment plan and maintain good hygiene practices to prevent recurrence. In rare cases, tinea manuum can lead to complications such as secondary bacterial infection, but these are generally uncommon.
Clinical history
The clinical history of a patient with tinea manuum typically includes:
Itching: The affected person may experience itching on one or both hands.
Scaling: The skin on the hands may become dry, scaly, and flaky.
Redness: The skin on the hands may become red and inflamed.
Rash: The affected person may develop a rash on the hands that may be raised and have a circular shape.
Pain: Some people may experience pain on their hands due to the fungal infection.
Previous fungal infection: The affected person may have a history of other fungal infections, such as tinea pedis (athlete’s foot).
Exposure to fungi: The person may have had recent exposure to fungi in moist or warm environments, such as locker rooms or swimming pools.
Immunocompromised status: People with weakened immune systems, such as those with HIV or who are undergoing chemotherapy, may be more susceptible to fungal infections, including tinea manuum.
Poor hygiene: People who do not practice good hygiene, such as washing their hands regularly, may be more prone to developing fungal infections on their hands.
Contact with infected individuals: The person may have had contact with someone who has a fungal infection, increasing their risk of developing tinea manuum.
Physical examination
During the physical examination of a patient suspected of having tinea manuum, the healthcare provider may perform the following:
Inspection of the affected area: The provider will examine the hands to check for signs of a fungal infection, including redness, scaling, flaking, and a circular rash.
Palpation of the affected area: The provider may gently press on the affected area to check for tenderness or pain, which may indicate a more severe infection.
Examination of the nails: The provider may also examine the fingernails to check for signs of a fungal infection, such as thickening, discoloration, or separation from the nail bed.
Scraping of skin samples: The provider may use a scalpel or a blade to scrape off a small sample of skin from the affected area. The sample will be examined under a microscope to confirm the diagnosis of tinea manuum.
Wood’s lamp examination: A Wood’s lamp emits ultraviolet light that can help to identify certain types of fungal infections. The provider may use a Wood’s lamp to examine the affected area and look for any fluorescence, which may indicate the presence of a fungal infection.
Differential diagnosis: The provider may also consider other conditions that can cause similar symptoms, such as eczema, psoriasis, or contact dermatitis.
Differential diagnosis
The differential diagnosis of tinea manuum includes several conditions that can cause similar symptoms. Some of these conditions are:
Psoriasis: Psoriasis can cause scaly, red, and itchy patches on the hands that may resemble tinea manuum.
Contact dermatitis: Exposure to irritants or allergens can cause a rash on the hands that may be similar to tinea manuum.
Eczema: Eczema can cause red, dry, and itchy patches on the hands that may be mistaken for tinea manuum.
Dyshidrotic eczema: Dyshidrotic eczema is a type of eczema that specifically affects the hands and feet. It can cause small blisters on the hands that may resemble tinea manuum.
Pityriasis rosea: Pityriasis rosea is a viral infection that can cause a rash on the trunk, arms, and legs. It may also affect the hands and cause symptoms similar to tinea manuum.
Scabies: Scabies is a parasitic infection that can cause intense itching and a rash on the hands and other parts of the body.
Systemic lupus erythematosus (SLE): SLE is an autoimmune disorder that can cause a rash on the hands and other parts of the body, as well as joint pain, fatigue, and other symptoms.
These are just a few of the conditions that can cause symptoms similar to tinea manuum. A healthcare provider will consider a patient’s medical history, physical examination, and laboratory tests to make an accurate diagnosis.
The treatment of tinea manuum typically involves topical or oral antifungal medications, as well as measures to prevent the spread of the infection. The specific treatment approach may depend on the severity of the infection and the underlying cause. Here are some treatment options:
Topical antifungal medications: Creams, ointments, or lotions containing antifungal agents such as clotrimazole, miconazole, or terbinafine can be applied directly to the affected area.
Oral antifungal medications: In more severe cases of tinea manuum or when topical treatments are not effective, oral antifungal medications such as terbinafine, itraconazole, or fluconazole may be prescribed.
Good hygiene: Patients with tinea manuum should maintain good hygiene practices, including frequent hand washing and avoiding sharing of personal items such as towels or clothing.
Avoiding irritants: Patients should avoid exposure to irritants that can worsen the infection, such as harsh soaps or chemicals.
Addressing underlying conditions: If the tinea manuum infection is associated with an underlying condition, such as a weakened immune system or diabetes, the underlying condition should be treated.
It is important to note that treatment for tinea manuum may take several weeks to be effective, and patients should continue treatment as directed by their healthcare provider to ensure complete resolution of the infection.
https://www.ncbi.nlm.nih.gov/books/NBK559048/
medtigo
Tinea Manuum
Updated :
August 30, 2023
Tinea manuum is a fungal infection of the hand that is caused by dermatophyte fungi. It is similar to other types of tinea infections, such as tinea pedis (athlete’s foot) and tinea corporis (ringworm) but occurs specifically on the hand.
Tinea manuum can affect one or both hands and is more common in people who have frequent contact with contaminated surfaces or objects, such as athletes, healthcare workers, and people who work with animals.
The epidemiology of tinea manuum is not well documented in the medical literature, but it is generally considered to be a relatively uncommon condition. The incidence and prevalence of tinea manuum may vary depending on factors such as age, gender, occupation, and geographic location. Tinea manuum is more commonly seen in adults than children, and it appears to be more common in women than men.
People who work in occupations that involve frequent contact with contaminated surfaces or objects, such as athletes, healthcare workers, and people who work with animals, may be at increased risk for developing tinea manuum. Geographic location may also play a role in the prevalence of tinea manuum, as some regions have a higher incidence of fungal infections due to environmental factors such as temperature, humidity, and exposure to fungi.
For example, tinea manuum may be more common in warm, humid climates or in areas with poor sanitation or hygiene. Overall, the exact epidemiology of tinea manuum is not well established, and more research is needed to understand the prevalence and incidence of this condition in different populations.
Tinea manuum is a fungal infection caused by dermatophyte fungi. These fungi are known for their ability to grow and thrive in warm, moist environments, such as those found on the hands. The pathophysiology of tinea manuum involves the invasion of the fungal spores into the skin of the hands, where they grow and multiply.
The infection can occur through direct contact with contaminated objects or surfaces, such as towels, clothing, or gym equipment, or through contact with an infected person. Once the fungi have entered the skin, they begin to produce enzymes that break down the keratin proteins in the skin. This process leads to the characteristic symptoms of tinea manuum, including redness, scaling, and itching of the affected area. The rash may be dry or moist and may develop blisters or pustules in severe cases.
In some cases, tinea manuum can spread to other areas of the body, such as the feet, groin, or scalp, causing additional symptoms and complications. Fungal nail infections may also occur as a result of tinea manuum. The pathophysiology of tinea manuum can be effectively treated with antifungal medications that target the underlying fungal infection. Topical or oral antifungal medications are typically used to eliminate the fungi and prevent the infection from spreading to other areas of the body.
The etiology of tinea manuum is a fungal infection caused by dermatophyte fungi. These fungi are known for their ability to grow and thrive in warm, moist environments, such as those found on the hands. The most common dermatophyte fungi responsible for tinea manuum are Trichophyton rubrum and Trichophyton mentagrophytes.
These fungi can be found in various environments, such as locker rooms, public showers, and other communal spaces. Direct contact with infected surfaces, objects, or persons can lead to the transmission of these fungi to the hands.
Factors that increase the risk of tinea manuum include:
Frequent hand washing or exposure to water.
Sweaty hands or gloves.
Compromised immune system.
Occupation that involves frequent contact with contaminated surfaces or objects, such as healthcare workers, athletes, and people who work with animals.
Diabetes or other medical conditions that affect circulation or the immune system.
Tinea manuum can also develop as a result of a pre-existing fungal infection in another part of the body, such as the feet or groin. In these cases, the infection can spread to the hands through contact with the affected area. Overall, the etiology of tinea manuum is a fungal infection caused by dermatophyte fungi, which can be transmitted through direct contact with contaminated surfaces, objects, or persons.
The prognosis for tinea manuum is generally good with appropriate treatment. Most cases of tinea manuum can be effectively treated with topical or oral antifungal medications, and symptoms usually resolve within several weeks to months. However, recurrence of the infection is possible, especially if the underlying conditions that contributed to the infection are not addressed.
Patients with tinea manuum should follow their healthcare provider’s recommended treatment plan and maintain good hygiene practices to prevent recurrence. In rare cases, tinea manuum can lead to complications such as secondary bacterial infection, but these are generally uncommon.
Clinical history
The clinical history of a patient with tinea manuum typically includes:
Itching: The affected person may experience itching on one or both hands.
Scaling: The skin on the hands may become dry, scaly, and flaky.
Redness: The skin on the hands may become red and inflamed.
Rash: The affected person may develop a rash on the hands that may be raised and have a circular shape.
Pain: Some people may experience pain on their hands due to the fungal infection.
Previous fungal infection: The affected person may have a history of other fungal infections, such as tinea pedis (athlete’s foot).
Exposure to fungi: The person may have had recent exposure to fungi in moist or warm environments, such as locker rooms or swimming pools.
Immunocompromised status: People with weakened immune systems, such as those with HIV or who are undergoing chemotherapy, may be more susceptible to fungal infections, including tinea manuum.
Poor hygiene: People who do not practice good hygiene, such as washing their hands regularly, may be more prone to developing fungal infections on their hands.
Contact with infected individuals: The person may have had contact with someone who has a fungal infection, increasing their risk of developing tinea manuum.
Physical examination
During the physical examination of a patient suspected of having tinea manuum, the healthcare provider may perform the following:
Inspection of the affected area: The provider will examine the hands to check for signs of a fungal infection, including redness, scaling, flaking, and a circular rash.
Palpation of the affected area: The provider may gently press on the affected area to check for tenderness or pain, which may indicate a more severe infection.
Examination of the nails: The provider may also examine the fingernails to check for signs of a fungal infection, such as thickening, discoloration, or separation from the nail bed.
Scraping of skin samples: The provider may use a scalpel or a blade to scrape off a small sample of skin from the affected area. The sample will be examined under a microscope to confirm the diagnosis of tinea manuum.
Wood’s lamp examination: A Wood’s lamp emits ultraviolet light that can help to identify certain types of fungal infections. The provider may use a Wood’s lamp to examine the affected area and look for any fluorescence, which may indicate the presence of a fungal infection.
Differential diagnosis: The provider may also consider other conditions that can cause similar symptoms, such as eczema, psoriasis, or contact dermatitis.
Differential diagnosis
The differential diagnosis of tinea manuum includes several conditions that can cause similar symptoms. Some of these conditions are:
Psoriasis: Psoriasis can cause scaly, red, and itchy patches on the hands that may resemble tinea manuum.
Contact dermatitis: Exposure to irritants or allergens can cause a rash on the hands that may be similar to tinea manuum.
Eczema: Eczema can cause red, dry, and itchy patches on the hands that may be mistaken for tinea manuum.
Dyshidrotic eczema: Dyshidrotic eczema is a type of eczema that specifically affects the hands and feet. It can cause small blisters on the hands that may resemble tinea manuum.
Pityriasis rosea: Pityriasis rosea is a viral infection that can cause a rash on the trunk, arms, and legs. It may also affect the hands and cause symptoms similar to tinea manuum.
Scabies: Scabies is a parasitic infection that can cause intense itching and a rash on the hands and other parts of the body.
Systemic lupus erythematosus (SLE): SLE is an autoimmune disorder that can cause a rash on the hands and other parts of the body, as well as joint pain, fatigue, and other symptoms.
These are just a few of the conditions that can cause symptoms similar to tinea manuum. A healthcare provider will consider a patient’s medical history, physical examination, and laboratory tests to make an accurate diagnosis.
The treatment of tinea manuum typically involves topical or oral antifungal medications, as well as measures to prevent the spread of the infection. The specific treatment approach may depend on the severity of the infection and the underlying cause. Here are some treatment options:
Topical antifungal medications: Creams, ointments, or lotions containing antifungal agents such as clotrimazole, miconazole, or terbinafine can be applied directly to the affected area.
Oral antifungal medications: In more severe cases of tinea manuum or when topical treatments are not effective, oral antifungal medications such as terbinafine, itraconazole, or fluconazole may be prescribed.
Good hygiene: Patients with tinea manuum should maintain good hygiene practices, including frequent hand washing and avoiding sharing of personal items such as towels or clothing.
Avoiding irritants: Patients should avoid exposure to irritants that can worsen the infection, such as harsh soaps or chemicals.
Addressing underlying conditions: If the tinea manuum infection is associated with an underlying condition, such as a weakened immune system or diabetes, the underlying condition should be treated.
It is important to note that treatment for tinea manuum may take several weeks to be effective, and patients should continue treatment as directed by their healthcare provider to ensure complete resolution of the infection.
https://www.ncbi.nlm.nih.gov/books/NBK559048/
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