Abstract Two feet-one hand syndrome is a superficial fungal infections of the skin which involves both feet and one hand. Trichophyton rubrum and occasionally Trichophyton mentagrophytes are the usual causative organisms. We present a 32-year-old healthy man with sharply demarcated papular erythematous and squamous lesions on dorsal aspect of the feet and diffuse dry scaling lesions of the right palm. In this syndrome, the development of tinea pedis generally precedes the development of tinea manus, which usually occurs on the hand that excoriated the pruritic feet or picked the toenails with onychomycosis. Our patient often used his dominant right hand to scratch the feet. On mycological examination, fungal spores and mycelia were present and Trichophyton mentagrophytes was isolated. The patient was treated with itraconazole 200 mg daily for two weeks and topical terbinafine cream for four weeks. After the treatment all lesions resolved and fungal culture was negative. Early diagnoses and treatment of tinea pedis and education about prophylaxis, constant care and regular medical assistance would minimize this problem in predisposed individuals.
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