WhatsApp Usage during COVID-19 in Sudan for Diagnosis, Management and Follow-up of Severe Tinea Infection of Upper and Lower Extremities: Clinical Case: Severe Bilateral Tinea Pedis, Followed by Severe Bilateral Tinea Manuum

Our case details a 48-year-old female, asthmatic, not pregnant or lactating or at risk presenting with itching and erythema on both feet. Initially treated as a severe contact dermatitis with dermatologist for nine months in three visits without improvement. Six months later from the first visit, the patient observed that the problem involved both hands. Subsequent follow up and treatment regimens were failed, and the patient referred to internal medicine and oncology units. WhatsApp communication and follow up during COVID-19 was continued for three months with patient. Laboratory investigations potassium hydroxide [KOH] test, visualized scraping skin under microscopy confirmed the diagnosis of severe tinea pedis and tinea manuum. Liver and renal function tests, screening for diabetes and complete blood picture were normal. Terbinafine tablets 250 mg, Fucidin ointment for the inflamed red skin, desloratadine 5 mg, an emollient cream was administered. Despite prior misdiagnosis and treatment as contact dermatitis, our case demonstrates severe tinea pedis and tinea manuum with laboratory confirmation. Significant improvement includes well healed skin and no pruritis was achieved after 8 weeks course of oral terbinafine. Although tinea pedis and manuum diagnose clinically and sometimes cures without treatment but our case underscores the importance of accurate diagnosis in distinguishing severe tinea pedis and tinea manuum from conditions such as contact dermatitis, psoriasis, and pompholyx.