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Hand Dermatitis

Definition

Any type of eczema that develops on the hands can be classified as hand dermatitis. Also it is referred to as hand eczema. Actually it is a skin condition in which rashes develops on hands and they become dry, red, cracked and inflamed. Hand dermatitis varies in severity. It may affect the backs of the hands, the palms or both sites.

Often it starts as a mild intermittent complaint, but it can become increasingly severe and persistent.

Causes

It is caused by a combination of factors which includes constitutional factors, contact with allergy and irritants.

Causes include contact dermatitis are-

  • fungal infection
  • psoriasis and
  • scabies; some cases are idiopathic

And common causes by which hand dermatitis-

  • Hand washing
  • Detergents
  • Shampoo
  • PolishesSolvents
  • Citrus fruits
  • Hair lotions
  • Gloves
  • Rings

Symptoms

Common symptoms are-

  • Dry, chapped hands (may be first sign)
  • Later the hands tend to develop patches of red, scaly, and inflamed skin that can itch
  • Itchy blisters or other lesions may form, skin may crack and weep
  • Pus-filled lesions, crusting, and pain if skin becomes infected
  • Can spread beyond the hands, particularly to the forearms and feet, if a skin infection develops or an allergic reaction is not treated
  • Deformed nails when hand dermatitis persists for a long time

Treatment

Primary treatment for hand dermatitis is typically uses topical corticosteroids, especially when the offending agent(s) cannot be identified or avoided. However, patients may eventually develop tachyphylaxis to the anti-inflammatory activity of mid-potency or high-potency topical corticosteroids and patients with severe, chronic involvement may often be less likely to respond. There are limitations to treatment duration with mid- to ultra high-potency steroids due to dermal atrophy and other side-effects.

To prevent dermatitis returning regular application of moisturisers and avoiding irritants should be continued. Occasionally, patch testing by a dermatologist may be necessary to determine whether a true allergy to a chemical is occurring. If allergy does occur, then it is important to avoid contact with the chemical.

The study showed that 15% of the massage therapists surveyed had been diagnosed with hand eczema; 23% reported symptoms of the condition.

In resistant cases both topical and systemic PUVA is required. Short courses of systemic steroids, methotrexate and cyclosporine have occasionally been used in very disabling circumstances. The treatment for this usually involves the avoidance of irritants and aggressive use of moisturizers and barrier creams. Preparations including salicylic acid and tar can be of some benefit. In severe cases oral retinoids have been utilized.
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