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He reported having been working with old wooden materials in the days prior to the appearance of the lesion, with probable local trauma. No lymphadenopathy or lymphangitic spread were observed on palpation, but the presence of pustules at the edges of the lesion was noteworthy (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Given the context of trauma and the presence of an active pustular border, the diagnosis of inflammatory tinea manuum was made, prescribing oral itraconazole along with topical flutrimazole, after taking samples for culture of fungi, bacteria and herpes simplex virus PCR to rule out other causes such as herpetic whitlow, sporotrichosis or pyoderma. Direct observation with potassium hydroxide was doubtfully positive, but <span class="elsevierStyleItalic">Trichophyton mentagrophytes</span> was identified 10 days later, with the rest of the results being negative. A complete remission of the symptoms was observed 10 days after treatment initiation. In conclusion, the presence of an active vesiculopustular border should always make us consider an inflammatory tinea as the first diagnosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sahuquillo Torralba A, Navarro Mira MÁ, Botella Estrada R. Tiña inflamatoria de la mano: la importancia de las pústulas. Med Clin (Barc). 2017;149:e15.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 693 "Ancho" => 900 "Tamanyo" => 123325 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 563 "Ancho" => 750 "Tamanyo" => 76207 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014900000003/v1_201708260033/S2387020617304436/v1_201708260033/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014900000003/v1_201708260033/S2387020617304436/v1_201708260033/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617304436?idApp=UINPBA00004N" ]