(Disclaimer: This article is for scientific purposes only. In order to protect the privacy of Mr. Zhao, the relevant information in the following content has been processed) Abstract: The subject of this case is a 38-year-old man named Mr. Zhao, who reported that a red papule was found on the tiger’s mouth of his hand, accompanied by mild itching, which was ignored at that time. The itching gradually intensified, and due to repeated scratching, the red papules enlarged, while similar lesions appeared on the right hand. Based on Zhao’s pathogenesis, clinical manifestations, and fungal microscopy results, he was diagnosed with goose pimples. Oral + topical medication was given. After treatment, the hand lesions gradually faded, itching was reduced, and peeling subsided. Basic information] Male, 38 years old [Type of disease] Goosebumps [Hospital] Harbin Hospital of Traditional Chinese Medicine [Time of consultation] May 2022 [Treatment plan] Oral medication (terbinafine hydrochloride tablets) + topical medication (sertaconazole nitrate cream) [Cycle of treatment] 30 days of home medication [Effect of treatment] Gradual fading of lesions on the hands, reduction of itching, and desquamation of the skin. The main character of this case is 38-year-old Zhao, slightly fat, dark skin color, full of energy. After the consultation, he said: 2 months ago, after a sewer dredging work, the tiger’s mouth of the hand grew red pimples, with mild itching, at that time, I did not pay attention to it. In the past 2 months, the itching gradually intensified, and due to repeated scratching, the red papules expanded to the surrounding area, forming a patchy damage with clear edges and irregular morphology, and similar lesions appeared on the right hand, but the symptoms were relatively mild compared to those on the left hand. Physical examination: the left hand has a raised edge of about 5 cm in diameter, sunken in the middle, with clear boundaries, extending to the index, middle and ring fingers of the left hand, with scattered flakes above the lesions, which are relatively hard to touch with the hand. On the right hand, there were red scattered papules on the dorsal side of the middle and ring fingers, and red patches on the ring and middle fingers. Based on the onset of the disease and clinical manifestations, Zhao was initially considered to have goose pimples. After communicating with Mr. Zhao, Mr. Zhao agreed to perform fungal microscopy to clarify the diagnosis. Fungal microscopy showed that spores and hyphae were visible, which was consistent with the diagnosis of thrush. Treatment The goose pimples on Zhao’s hands had existed for 2 months and had a tendency to worsen. After clarifying the diagnosis and communicating with Zhao about the occurrence and development of the disease, the treatment plan was finalized. Oral terbinafine hydrochloride tablets and topical sertaconazole nitrate cream were chosen for treatment. The intake of terbinafine tablets can inhibit the metabolism and reproduction of fungi in superficial areas, and control the invasive spread of fungi on the skin surface of the hands from the inside out. Sertaconazole nitrate cream itself belongs to imidazole topical cream, which can inhibit the metabolism and reproduction of superficial fungi from the outside to the inside when applied to the skin surface. The disease was gradually cured through a combination of oral and topical treatments. After taking the medication and returning to the clinic, Mr. Zhao understood how to use the medication and said that he would use the medication regularly after going home. Mr. Zhao was told to return to the clinic at any time if he had any problems with the medication. Third, treatment effect After 30 days of using the medicine, Mr. Zhao made a telephone call back to the clinic. Mr. Zhao said that starting from the third day of using the medicine, the flakes adhering to the top of the local skin surface gradually decreased, the itching was obviously relieved, and he was able to sleep normally at night. Starting from the 7th day of using the drug, the local edge of the raised skin lesions gradually flattened, and the boundary gradually blurred. On the 15th day, the red patches and itchy papules on the right hand completely disappeared, and the surface symptoms on the left hand were significantly relieved, but the symptoms still existed. On the 21st day, the skin damage on the surface of the middle and ring fingers of the index finger of the left hand had subsided and basically returned to normal color. Tiger’s mouth area, although the skin has not completely disappeared, but the skin symptoms have been significantly improved. As of the phone call back to the medication for 30 days, the left hand symptoms basically disappeared, residual brown pigmentation. Mr. Zhao was instructed to continue using the medication and returned to the clinic 3 days later for a fungal review, which showed normal results. The result was normal. Mr. Zhao was happy that his symptoms gradually improved and the treatment effect was good. Goosebumps is contagious, so it is recommended not to have too close contact with others until it is completely cured to prevent it from spreading to others. Before the hands are completely cured, try to minimize the contact with liquid substances, to avoid excessive moisture in the hands, resulting in excessive fungal growth, affecting the therapeutic effect. Diet, pay attention to light not spicy. Oral terbinafine hydrochloride tablets are slightly stimulating to the liver and have hepatotoxicity, it is recommended that liver function be rechecked in the hospital on the 30th day of medication. Topical application of drugs in the process, once the emergence of intense itching, flushing, breaking, erosion and other symptoms, to stop the drug in time to consult a doctor, replace the drug alternative treatment. V. Personal Insight Goose pawpaw is a contact infectious disease triggered by fungal infection of the skin of the hands, which can cause intense itching. Early symptoms are not obvious, and it is easy to be confused with eczema and atopic dermatitis, which requires fungal examination for a clear diagnosis. Repeated scratching of the hands, as in this case, is undesirable and will lead to aggravation of the condition, and the feet should not be scratched, which may lead to fungal attack on the feet and trigger athlete’s foot. In daily life, pay attention to hand hygiene, if there are symptoms timely consultation, symptomatic treatment and care. Hand goose paws if accompanied by obvious keratinizing changes, in the choice to use topical antifungal ointment after the use of plastic wrap can be wrapped for 5-10 minutes, effectively improve the permeability of the drug, enhance the therapeutic effect.