B35.2 Tinea manuum

Name of the Condition

• Tinea manuum
  
  • Common name(s): Ringworm of the hand

Summary

Tinea manuum is a fungal infection affecting the skin of the hands, caused by dermatophyte fungi. It is characterized by scaly, itchy patches, often on the palms or between the fingers, and may involve one or both hands.

Causes

Tinea manuum is caused by dermatophyte fungi, most commonly Trichophyton rubrum or Trichophyton mentagrophytes. These fungi invade the keratinized layers of the skin, leading to infection. Transmission typically occurs through direct contact with infected individuals, animals, or contaminated surfaces (e.g., towels, tools).

Risk Factors

• Close contact with infected people or animals (e.g., pets)
• Sharing personal items (e.g., gloves, hand towels)
• Weakened immune system
• Occupational exposure to moist environments (e.g., farming, cleaning)
• Pre-existing tinea infections (e.g., athlete’s foot)

Symptoms

• Itchy, scaly patches on the palms or between the fingers
• Red, inflamed skin with possible blistering or cracking
• Dry, thickened skin in chronic cases
• Possible spread to nails (tinea unguium) if untreated

Diagnosis

Diagnosis involves a physical examination of the affected hand, skin scraping for microscopic analysis (KOH test), or fungal culture to identify the causative organism. Clinical presentation and history of exposure are also considered.

Treatment Options

• Topical antifungal creams or ointments for localized infections.
• Oral antifungal medications (e.g., terbinafine, itraconazole) for severe or widespread cases.
• Keeping hands dry and avoiding irritants to support healing.

Prognosis and Follow-Up

With appropriate treatment, tinea manuum generally resolves within 2–4 weeks. Follow-up may be recommended to monitor for recurrence, especially if risk factors persist. Chronic or untreated cases may lead to persistent skin changes.

Complications

• Secondary bacterial infections from cracked skin
• Chronic dermatitis or skin thickening
• Spread to other body parts (e.g., feet, nails)

Lifestyle & Prevention

• Maintain hand hygiene and keep hands dry.
• Avoid sharing personal items (e.g., towels, gloves).
• Wear protective gloves in moist or contaminated environments.
• Treat concurrent fungal infections (e.g., athlete’s foot) to prevent reinfection.

When to Seek Professional Help

Consult a healthcare provider if symptoms worsen, do not improve with over-the-counter treatments, or if there are signs of secondary infection (e.g., pus, increased pain).

Tips for Medical Coders

• Use B35.2 for tinea manuum. Document the affected hand(s) and any associated symptoms (e.g., scaling, itching) to support code specificity. Include details of exposure history or occupational risk factors if relevant to clinical context.