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Two Feet-One Hand Syndrome
1Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, University of Tokyo, Tokyo, JPN.
Cureus
|February 3, 2022
Summary
Ringworm infection, often misdiagnosed, can present as "two feet-one hand syndrome." Prompt recognition of this fungal rash pattern aids in effective treatment with topical antifungals like ketoconazole.
Area of Science:
- Dermatology
- Mycology
Background:
- Ringworm infection (tinea) is a common superficial fungal infection.
- Misdiagnosis of ringworm can delay appropriate treatment and lead to complications.
Observation:
- An 81-year-old woman presented with pruritic, crusted lesions on her right hand's third and fourth fingers and bilateral toes.
- Clinical examination revealed a distinct rash distribution affecting both feet and one hand.
Findings:
- Potassium hydroxide (KOH) testing confirmed the presence of filamentous fungi, indicative of dermatophytosis.
- The clinical presentation was consistent with the rare "two feet-one hand" syndrome, a specific pattern of ringworm infection.
Implications:
- Recognizing the "two feet-one hand" pattern is crucial for accurate and timely diagnosis of ringworm.
- Topical antifungal therapy, such as ketoconazole, is effective in treating this presentation of tinea manuum and tinea pedis.
