Dermatitis of the hands is quite common among children and adults, and in some European countries, about 10% of patients with dermatitis of the hands are registered for the first time every year. Hand dermatitis is not a dangerous disease, but it significantly reduces the quality of life of the patient and his social adaptation, requires long-term therapy with careful adherence to the treatment regimen, and its diagnosis can be difficult due to various clinical manifestations of the disease.
Dermatitis of the hands is a disease in which intraepidermal vesicles appear on the hands, and then the skin begins to peel off, itches and cracks.
Experts call atopic dermatitis an important factor that contributes to the development of hand dermatitis: almost every second patient with a history of atopic dermatitis goes to the doctor with complaints of hand dermatitis. Other triggers include exposure to allergens and irritants.
Forms of hand dermatitis and their clinical manifestations
There are three main clinical forms of hand dermatitis:
- contact dermatitis;
- pompholyx, or dyshidrotic eczema;
- Keratotic dermatitis of the palms.
Contact dermatitis
occurs primarily due to contact with environmental triggers such as irritants and allergens. It is usually localized on the thin skin of the hand, between the fingers and sometimes on the inner surface of the wrist. They mostly affect women. The course of the disease is divided into the acute phase – when, under the influence of irritants, edema occurs and vesicles form, and chronic – in which the skin is flaky, infiltration and painful cracks, slight itching appear.
Pompholyx
affects the entire skin of the palms, although it can also appear on the feet. The disease begins abruptly, with sudden, intensely itchy papules that can persist for about a week or even longer. Then the skin begins to peel and crack painfully.
Pompholyx has a chronic course, vesicular rashes reappear after a few weeks, can last for years, spontaneously disappear and recur, affecting both men and women. Provoking factors for the development of pompholyx can be smoking, allergies to nickel and some Compositae plants.
Keratotic dermatitis
of the hands is more common in middle-aged men and represents hyperkeratosis of the skin of the palms. The disease is most often provoked by multiple and multiple injuries of the palms. Keratotic dermatitis does not cause much distress either with itching or vesicles, but with cracks in the skin.
There are also mixed cases when hand dermatitis develops without taking into account the thickness of the skin, completely covers the entire skin of the hand, and when exposed to a very strong irritant or allergen, it acts anywhere on the skin regardless of its thickness.
Treatment of hand dermatitis depending on the form of the disease
The approach to the treatment of the three forms of hand dermatitis is different, but in any case, it is necessary, first of all, to weaken the effect of contact irritants on the skin and allergens.
In the treatment of contact dermatitis, topical steroid cream, emollients are used, with severe weeping – antibacterial products and antiseptic brush baths.
Pompholyx is difficult to treat. During the vesicular phase, local steroids are prescribed, in the chronic – emollients, in severe cases – prescribed methotrexate and cyclosporine.
Keratolytic drugs are recommended for patients with keratotic dermatitis – for example, ointments containing salicylic acid or tar. In severe cases, retinoids are prescribed.
It is very important that the patient agrees with the treatment regimen, understands the importance of following all the doctor's instructions and is ready for long-term therapy.
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