The First Patient with Tinea Manuum because of Isolated in Malta.

A 39-year-old woman presented to the dermatology department in January 2022 with a 3-week history of a progressively enlarging and intensely pruritic erythematous annular nodule on her left hand. The lesion started as a small blister, which was initially presumed to be a flare up of her pompholyx dermatitis. On her physician's advice, she applied clobetasol propionate ointment twice daily for 5 days; however the blister continued to increase in size until it burst, revealing raw inflamed skin. As the patch continued to increase in size, she was prescribed oral ciprofloxacin 500 mg twice a day for 5 days; however, the constantly weeping lesion grew to around 3 cm in diameter. The associated pruritus also became intense, without any response to regular antihistamines and ice application and disturbing patient's sleep. She also applied regular povidone iodine dressings but without any effect. Apart from pompholyx dermatitis, her medical history was significant for hypermobile Ehlers Danlos syndrome type 3 (hEDS).