In medicine, a finger tip unit (FTU) is defined as the amount of ointment, cream or other semi-solid dosage form expressed from a tube with a 5 mm diameter nozzle, applied from the distal skin-crease to the tip of the index finger of an adult.[1][2] The "distal skin-crease" is the skin crease over the joint nearest the end of the finger. One FTU is enough to treat an area of skin twice the size of the flat of an adult's hand with the fingers together, i.e. a "handprint". Two FTUs are approximately equivalent to 1 g of topical steroid.
One handprint is 0.8% (i.e. approximately 1%) of the total body surface area,[3] and one FTU covers approximately two handprints. As two FTUs are approximately equivalent to 1g of topical application, the "Rule of Hand" states that "4 hand areas = 2 FTU = 1 g".[4]
In the original study in the UK,[1] one FTU weighed 0.49 g in men and 0.43 g in women. The area covered by one FTU was 312 cm2 in men and 257 cm2 in women.[2] Very similar results were found in a Mexico study.[5] The weight of an FTU has been recalculated in Japan, relating to the use of 5 g tubes of ointment with a much smaller nozzle diameter.[6] The weight of ointment is less if the nozzle diameter is smaller than the standard 5 mm.
When a topical drug was used as a foam, the weight of an FTU was 52.5 μg: the area covered by one foam FTU was less than that of an FTU of cream.[7]
^ abFinlay AY, Edwards PH, Harding KG. “Fingertip unit” in dermatology. Lancet 1989; II, 155.
^ abLong CC, Finlay AY. The fingertip unit: a new practical measure. Clin Exper Dermatol 1991; 16: 444-446.
^Thomas CL, Finlay AY. The “handprint” approximates to 1% of the total body surface area whereas the "palm minus the fingers" does not. British Journal of Dermatology 2007; 157: 1080-1081.
^Long CC, Finlay AY, Averill RW. The rule of hand: 4 hand areas = 2 FTU = 1 g. Arch Dermatol 1992; 128: 1130-1131.
^Castanedo-Cazares JP, Torres-Alvarez B, Martinez-Rodriguez A, Diaz-Rosales A, Moncada B. Analysis of the digital unit as reference measurement for the topical prescription in Mexico (in Spanish). Gac Med Mex 2006; 142: 35-38.
^Dekio I, Morita E. The weight of a finger-tip unit of ointment in 5-gram tubes. J Dermatolog Treat 2011; 22: 302-3.
^Feldman SR, Sangha N, Setaluri V. Topical corticosteroid in foam vehicle offers comparable coverage compared with traditional vehicles. J Am Acad Dermatol 2000; 42: 1017-1020.
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