Hand dermatitis

Hand dermatitis

Chris Schach

Author Bio -

Key Points
*Skin condition affecting the hands, with varying severity
*Caused by a combination of factors
*Consists initially dry, red skin, leading to itchy bumps and blisters, scaling, cracking and swelling

Hand dermatitis is a skin condition of varying severity, and most often caused by a combination of factors. While it most commonly affects the hands, it can affect other areas of the body in long standing cases. The condition consists initially of skin in the affected area become red and dry. Initial reactions are generally mild and only intermittent. This will progress into the development of itchy bumps and blisters. This may also be accompanied by scaling, weeping, swelling, and cracking of the affected area. In persistent cases, secondary bacterial infections may develop, and the condition may spread to the forearms or feet.

Hand Dermatitis can affect anyone, and is caused by a number of determining factors, including constitutional factors, injury, and allergy. Constitutional factors include genetics (those with a family history of dermatitis, asthma, and/or hayfever), a personal history of other skin conditions (such as psoriasis), and even increased emotional stress. Injury factors generally refer to frequent contact with skin irritants, most commonly frequent water immersion in combination with detergents (soap, shampoos, etc.) and solvents (turpentine). Friction and repetitive exposure to these irritants leads to a worsening of the condition, with even a brief exposure causing a months-long flaring of the condition. Allergy factors refer primarily to specific hypersensitivity to a common substance, including certain metals, fragrances, rubber, and hair dye.

Differential Diagnosis (Other conditions with similar appearance)
Psoriasis
Palmoplantar pustulosis
Tinea manuum
Exfoliative keratolysis
Bowen’s disease

    Diagnosis
    Key Points
    *Diagnosis initially based on appearance of the affected area
    *Patch tests may be performed to determine the causal agent

    Hand dermatitis is initially diagnosed based on the appearance of the affected area. Patch tests may then be performed to determine the causal allergen, or irritant, if one exists.

    Treatment
    *Complete recovery with careful treatment is typical
    *Goal of treatment is to treat symptoms and eliminate the causal agent, if possible
    *Management of the condition by affected person is key in successful treatment
    OTC Options: Emollient creams

    Complete recovery of hand dermatitis is typical, when combined with treatment and careful management of the condition by affected persons. Avoiding irritants and allergens, proper hand protection (vinyl gloves) for short periods, and the frequent use of emollient creams to form a barrier to irritants are recommended for avoiding flare-ups. Topical steroids may also be prescribed to assist in reducing inflammation of the affected area. Additionally, a secondary bacterial infection may be treated with topical or oral antibiotic courses. In severe or persistent cases, oral steroid courses or other immunosuppressants may be prescribed, in addition to PUVA, an ultraviolet radiation therapy.

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