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finger tip unit : ウィキペディア英語版
finger tip unit
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 5mm diameter nozzle, applied from the distal skin-crease to the tip of the index finger of an adult.〔Finlay AY, Edwards PH, Harding KG. “Fingertip unit” in dermatology. Lancet 1989; II, 155.〕〔Long CC, Finlay AY. The fingertip unit: a new practical measure. Clin Exper Dermatol 1991; 16: 444-446.〕 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 1g of topical steroid.
One handprint is 0.8% (i.e. approximately 1%) of the total body surface area,〔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.〕 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 = 1g”.〔Long CC, Finlay AY, Averill RW. The rule of hand: 4 hand areas = 2FTU = 1g. Arch Dermatol 1992; 128: 1130-1131.〕
In the original study in the UK,〔Finlay AY, Edwards PH, Harding KG. “Fingertip unit” in dermatology. Lancet 1989; II, 155.〕 one FTU weighed 0.49g in men and 0.43g in women. The area covered by one FTU was 312 cm² in men and 257 cm² in women.〔Long CC, Finlay AY. The fingertip unit: a new practical measure. Clin Exper Dermatol 1991; 16: 444-446.〕 Very similar results were found in a Mexico study.〔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.〕 The weight of an FTU has been recalculated in Japan, relating to the use of 5g tubes of ointment with a much smaller nozzle diameter. 〔 Dekio I, Morita E. The weight of a finger-tip unit of ointment in 5-gram tubes. J Dermatolog Treat 2011; 22: 302-3.〕 The weight of ointment is less if the nozzle diameter is smaller than the standard 5mm.
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.〔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.〕
== Clinical use of FTU in patients ==

The FTU is particularly useful when counseling patients with regards to the amount of topical steroid cream they should be applying in order to minimize the side-effects which are associated with their use. The FTU can also be used in children.〔Long CC, Mills C, Finlay AY. A practical guide to topical therapy in children. Br J Dermatol 1998; 138: 293-296.〕
The FTU concept has been used as a central part of an education programme for parents of children with atopic eczema.〔Futamura M1, Ito K, Otsuji K, Hirayama M, Hayashi K, Ohya Y, Masuko I.(of "Skin Care School," a parental education program on childhood atopic dermatitis conducted during short hospitalization stays ).(in Japanese ) Arerugi. 2009 Dec;58(12):1610-8.〕
The use of the FTU has been advocated to reduce the variation in usage of topical steroids 〔McHenry PM, Williams HC, Bingham EA. Management of atopic eczema. Joint workshop of the British Association of Dermatologists and the Royal College of Physicians of London. BMJ 1995;310(6983): 843-847.〕 and to encourage adherence to therapy.〔Feldman SR, Horn EJ, Balkrishnan R, Basra MKA, Finlay AY, McCoy D, Menter A, van de Kerkhof P. Psoriasis: improving adherence to therapy. J Am Acad Dermatol 2008; 59: 1009-1016.〕 The FTU can also be used to guide the use of topical sunscreens.〔Diffey BL. What can be done to reduce personal ultraviolet radiation exposure? Chapter 13 in: Prevention of skin cancer. Editors Hill DJ, Elwood JM, English DR. Kluwer Academic Publishers, Dordrecht, 2004.〕

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