Cracks in the skin between the fingers? Could it be contact dermatitis?

Patients with painfully chapped skin between the fingers or reddened itchy spots on the skin of the hands at the doctor's appointment need, first of all, a soothing conversation. Acute manifestations of this dermatosis are often very frightening for patients, and we are probably talking about contact dermatitis, which is caused by external skin irritation with aggressive substances, allergens, or even active sunlight. Correct and accurate diagnosis will help determine the cause of skin damage, and quickly prescribe  treatment.

 

Contact dermatitis is an inflammation of the epidermis with fluid accumulation in the intercellular spaces. The disease  is caused by external factors affecting the skin – irritants, allergens, ultraviolet rays. It is one of the most common dermatoses of the hands, and, according to experts, the number of primary visits to dermatologists for contact dermatitis is growing every year around the world.

 

Contact dermatitis: causes and manifestations

Contact dermatitis most often develops from accidental exposure to strong irritants, most often of a chemical nature – acids, alkalis (including those included in detergents and other household products). Skin damage occurs due to the removal of the lipid layer by irritants, the destruction of keratin, and changes in the skin's ability to retain water.

Manifestations of contact dermatitis range from mild dry skin to intense redness and cracking. Strong stimuli cause an acute reaction in all people, weak – only for people with sensitive skin. People are most prone to acute manifestations of contact dermatitis & nbsp; with fair skin and those with a history of atopic dermatitis.

Repeated manifestations of contact dermatitis may occur as a result of milder damaging effects – such as friction of clothing, microtrauma, extreme heat or, conversely, very low temperatures, low air humidity, household use of soap, washing powder and other skin-degreasing substances. Any substance can provoke contact dermatitis if used for a long time and in high concentrations. Chronic contact dermatitis results from exposure of the skin to a combination of irritants, none of which alone would cause dermatitis.

Contact dermatitis usually affects areas with thin skin – interdigital spaces, the back surface of the palms, sometimes the skin on the crook of the wrist. The disease can manifest itself in different ways: erythema, edema, itching, manifestations of a rash. The chronic form of contact dermatitis is characterized by thickening of the skin, peeling, lichenification.

 

Key recommendations for the treatment of contact dermatitis

Therapy of contact dermatitis is based primarily on accurate diagnosis – determining the irritating factor and excluding its effect on the skin. Important principles for the treatment of acute contact dermatitis are as follows:

encourage and calm the patient, provide him with rest, explain the nature of the disease;

Protect the affected areas of the skin from irritation, including sunlight and rubbing against clothing;

prescribe skin emollients;

use soothing topical preparations (zinc cream, white petroleum jelly).

Preparations for the treatment of contact dermatitis should contain as many fatty acids as possible to moisturize the skin, and as few as possible to dry out components.

Topical corticosteroids are used for subacute contact dermatitis, but it should be remembered that although they suppress inflammation, they greatly thin the skin, disrupting its barrier functions. In addition, it must be borne in mind that the use of local & nbsp; corticosteroids can cause persistent contact dermatitis due to allergies to drugs of this series.

If there is a high probability of secondary infection, antibacterial drugs are prescribed, antihistamines will help relieve itching. For severe acute contact dermatitis, a course of systemic corticosteroids is recommended.

The patient should be advised to take baths with oil additives, use skin softeners after each hand wash, and warn that his skin will remain extremely sensitive long after recovery.