ringworm
Introduction
Introduction to handcuffs Handcuffs are fungal diseases that occur in the palm of the hand. They are commonly called goose palms. They are mainly caused by the infection of athlete's foot. The use of hands to dig feet is the main contagion factor. Because the hands are bare, the fingers are well ventilated and dry, and the incidence of handcuffs is not as high as enough. However, in recent years, as the number of athletes with ankles has increased, the number of patients with handcuffs has also increased. Suffering from handcuffs, not only feels inconvenient work, sometimes itching and uncomfortable, but also hinders hygiene, because the hand is a must-have "tool", which also affects the cleanliness of eating, creating conditions for "sickness from the mouth." The pathogenic fungi causing the handcuffs are basically identical to the pathogenic fungi of the foot. basic knowledge The proportion of sickness: 0.5% - 0.8% Susceptible people: no special people Mode of infection: contact spread Complications: hand, foot, body, body, femoral hernia
Cause
Handcuffs
Bacterial infection (35%):
The pathogen of handcuffs is basically the same as that of athlete's foot, mainly T. rubrum, followed by T. rubrum, which is often caused by sputum grabbing, body and femoral hernia.
Environmental factors (45%):
Hand trauma is a common cause. The disease occurs all over the world. The incidence rate is related to occupation. Miners, shoemakers and workers with more manual operation are prone to this disease.
Pathogenesis
As with the femoral hernia, airtight clothing can increase the temperature and humidity of the skin and interfere with the barrier function of the stratum corneum. After the infestation of Trichophyton rubrum and Trichophyton rubrum, several stages of development, including incubation period In the process of increasing and deteriorating during the anti-infection process, the growth period is in the stratum corneum and the clinical manifestation is slight. Once the infection is established, the growth rate of T. rubrum and T. rubrum and the rate of epidermal renewal are two key factors for the development of damage. Sex factors, the two must be equal or the former is greater than the latter, otherwise the number of Trichophyton and Trichophyton mentagrote will decrease, and the keratinase and other proteolytic enzymes produced by Trichophyton and Trichophyton mentagrophyta are not only Skin colonization and invasion, and manifested as skin damage.
Prevention
Handcuffs prevention
Avoid direct contact with infectious sources (such as frequent catching of athlete's foot), reduce the acid and alkaline substances in daily life work, the key is to pay attention to personal, family and collective health.
1. Pay attention to personal hygiene, do not use public slippers, foot basins, cloth, etc., shoes and socks, foot cloth should be regular, keep the feet clean, dry and sterilized.
2. Excessive sweating and injury in the hands and feet is often one of the most common causes of ankles or handcuffs. Usually, it is necessary to reduce the chemical, physical and biological substances to the bad skin of the opponent's foot. If the patient drinks less irritating beverages, such as Strong tea, coffee, alcohol, etc., because these beverages stimulate the secretion and excretion of sweat glands, providing a favorable environment for the susceptibility of epidermis mold.
3. After washing your feet or taking a bath at night, you should pour the moisture between the toes and puffs. Disinfect the spreading powder (0.1 ml of menthol, 2 g of thymol iodide, 4 g of zinc stearate, 2 g of magnesium carbonate, boric acid). 15 grams, talc powder is added to 100 grams), the purpose is to keep the toes between the toes as much as possible to prevent re-infection of the epidermis mold.
4. Footwear, foot cloth should be sterilized regularly, keep the foot clean and dry bathroom, swimming pool and other public places is the main place to infect enough athletes, the disinfection management system should be strictly implemented.
5. Cleanse yourself and not have unfair sexual relations with others. Do not use other people's underwear, underwear and toiletries.
6. Change the underwear frequently and keep the genitals clean, often washing the clothes.
7. Reduce sweating and promote evaporation of the roots of the femur. Try to keep the perineum dry and wear loose fit underwear. Don't overtighten.
Complication
Handcuffs complications Complications
Such as suffering from onychomycosis, goose palm, femoral hernia, should be actively treated to prevent infection in the genital area.
Symptom
Handkerchief Symptoms Common Symptoms Pustules, face, hands, peeling, skin, itching, papules, skin, cleft palate
The initial damage of the handcuffs is a small blisters on the fingertips, finger flexion or palmar surface, and desquamation after drying. It is often limited to one or two fingertips on one side, and gradually spreads to adjacent fingers or palms. Opposite side. The skin at the desquamation area can be thick and thick, the skin texture is wide, and the normal luster and elasticity are lost. Occasionally, the finger is smashed, and it is also caused by Candida albicans, not the common sputum. Handcuffs can be divided into blisters, scales or chronic eczema. The course of the disease is mostly chronic, the constant year is not cured, the skin lesions are aggravated in summer, the range is enlarged, and when the winter climate is dry, the skin lesions are coarse and thick. At the fingertips and joint active parts, due to the pulling effect during labor and work, it is easy to cause cracking, which often affects work and life.
According to different clinical characteristics, handcuffs can be divided into three types:
Blister scale
The onset is mostly a single case. It starts with a certain part of the palm, especially the palm, the palm of the index finger and the ring finger, the side and the root, starting with a needle-sized blisters, thick and shiny, containing a clear liquid. Blisters gather or evacuate in groups, consciously itching, blister dry after desquamation and gradually spread to the surrounding to form a ring or multiple ring damage, clear edges, chronic disease, lasting for many years, until all palms are involved and spread to the back of the hand and nails, and even Contralateral palm. Sometimes vesicles can be secondary to infection to form pustules.
Hyperkeratosis
Occurs in the palm of the hand (if it is enough, it is the heel). The skin is mostly dry, the keratin is thickened, the surface is rough and desquamated, the texture is deepened, and the cleft palate is prone to occur, and the skin lesion can spread to the back of the hand (the back of the foot). Generally no itching, there is pain when cleft palate.
Impregnated erosive type
Also called the rubbing type, it is good to the finger (toe) seam. It is characterized by whitening and whitening of the skin, and the surface is soft and easy to peel off, exposing the flushing surface and even the cracks. There are varying degrees of itching, and there is a foul smell in the secondary bacterial infection.
The disease often exists as a type or a combination of several types, and can also be changed from one type to another, as in the summer, the blister scaly type, and in winter, the keratosis type. Incomplete treatment is the main reason for prolonged unhealed.
Examine
Handcuffs inspection
Mycological examination of scaly or blister wall for direct microscopic examination, can be found in hyphae or joint spores, keratinization type of bacteria detection rate is low.
Histopathology: acute phase epidermis with intercellular edema, sponge formation, cell infiltration, blister located under the epidermis horn, may have parakeratosis, chronic keratosis, acanthosis thickening and chronic inflammatory infiltration, with PAS Dyeing can find fungal hyphae in the stratum corneum.
Diagnosis
Handcuff diagnosis
Diagnostic points
1. The rash occurs on the side of the finger, on the flex side, between the fingers, and on the palm and palm. The rash is often limited to one side.
2, often in the summer onset or aggravation, winter is getting better.
3, the rash form is divided into blister type, scaly type, erosive type. Each type can be transformed into each other, or it can exist at the same time, but in a certain period, the performance of one type is often dominant.
(1) blister type: The rash is a deep blister, scattered or clustered, with a small amount of scale after rupture or absorption. Conscious pruritus is obvious, often due to scratching or self-use needle to pick up vesicles and secondary infection.
(2) Scale type: manifested as hyperkeratosis, dry, rough, desquamation, and pale red base. It can happen with one hand or both hands. Consciously itching is light, and often chapped and pain in winter.
(3) erosive type: more often between the fingers. The local epidermis is moist, impregnated and whitish, and it is consciously itchy. After the epidermis is broken, the flushed surface of the flushing is exposed, and at this time, itching and burning pain are felt. Often due to catching and secondary infection.
4, the course of the disease is slow, usually not healed for many years.
5, can be used for direct microscopic examination of fungi or fungal culture examination to further confirm the diagnosis.
Differential diagnosis
Hand eczema
Hand eczema and handcuffs are common hand skin diseases. Patients with hand eczema are allergic to the body, because the hands often contact with various sensitizing factors outside, such as disinfectants, detergents, chemicals, etc. The rash is dark erythema, the surface of the skin is dry and rough, and it can also be hypertrophic, often accompanied by chapped in winter, with varying degrees of itching, and pain when the skin is cleft.
Exfoliative keratosis
Also known as lamellar sweating, it is a superficial palmar horny exfoliative skin disease. The skin lesions begin with needle white spots, which are formed by the release of epidermis, gradually expanding desquamation, no papules and blisters. There is no itching, the hands are symmetrical, more common in adolescents, often have a tendency to seasonal recurrence.
Sweat herpes
The typical damage is the size of the blister in the depth of the epidermis, slightly higher than the skin surface, no inflammation, often symmetrically distributed in the palm, finger side and fingertips, rare in the back of the hand and the foot, can be repeated repeatedly. The blister wall fungus was negative. Note the difference between the shampoo and the handkerchief.
Hand blistering rash
The blister is shallow and the blister wall is thin. It is often clustered and symmetrically distributed between the fingers and the palm. The other parts of the body also have active dermatophytosis. The blister wall fungus was negative, but the trichostatin test was strongly positive. The sputum rashes naturally disappear after the dermatophytosis is cured.
