What is the recommended treatment for tinea manuum (ringworm of the hand)?

From the Guidelines

Tinea manuum is best treated with topical antifungal medications such as terbinafine, clotrimazole, or miconazole applied twice daily for 2-4 weeks. For mild to moderate cases, these topical treatments are typically sufficient, as they work by disrupting the fungal cell membrane or inhibiting ergosterol synthesis, which is essential for fungal cell growth 1. It is essential to apply the cream to the affected areas and slightly beyond the visible border of the infection to ensure complete coverage. Some key points to consider when treating tinea manuum include:

• Continue treatment for at least one week after symptoms have resolved to prevent recurrence
• Good hand hygiene is crucial during treatment, including keeping hands dry, avoiding prolonged water exposure, and using separate towels to prevent spread to other body parts or individuals
• Treatment of any concurrent tinea pedis (athlete's foot) is also important as it often serves as a reservoir for reinfection For severe or resistant cases, oral antifungal medications like terbinafine 250mg daily for 2-4 weeks or itraconazole 200mg daily for 1-2 weeks may be necessary, with terbinafine appearing superior for certain types of fungal infections, such as those caused by Trichophyton tonsurans 1.

From the Research

Treatment Options for Tinea Manuum

• Tinea manuum is a dermatophyte infection of the hands, and its treatment is similar to that of other tinea infections [ 2, 3 ].
• Topical therapy is generally successful unless the infection covers an extensive area or is resistant to initial therapy 2.
• Treatment requires attention to exacerbating factors such as skin moisture and choosing an appropriate antifungal agent 2.
• Newer medications require fewer applications and a shorter duration of use 2.

Recommended Treatment Duration

• Tinea corporis and cruris infections are usually treated for two weeks, while tinea pedis is treated for four weeks with an azole or for one to two weeks with allylamine medication 2.
• Treatment should continue for at least one week after clinical clearing of infection 2.

Antifungal Agents

• Effective antifungal agents for tinea infections include fluconazole, itraconazole, and terbinafine 4, 5, 6.
• The choice of antifungal agent depends on the severity of the infection, the patient's medical history, and the potential for drug interactions 4, 5, 6.