Most people suffer from mild degrees of hand eczema, as dryness or chapping, sometime or other during their life time. Hand dermatitis is more common in females to the ratio of 2:1.
Pompholyx
Pompholyx is also known as dyshidrotic eczema or vesicular eczema of the palms and soles, as most of the time the soles are also affected. Tense fluid filled, intensely itchy vesicles appear on the sides of fingers and palm. Hereditary predisposition, emotional stress, ide eruption to fungal or bacterial infections, ingested allergens, chromate and nickel sensitivity all have been cited as causes for pompholyx.
Recurrent Focal Palmar Peeling
Previously known as keratolysis exfolitiva, this is probably a minor form of pompholyx. Mostly in summer, small areas of scaling appear on the palms and soles and peel off abruptly. These are self limiting and require no treatment.
Hyperkeratotic Palmar Eczema
Thought to be the result of chronic irritant contact dermatitis, this type of thick, keratotic scaly hand eczema, also known as tylotic eczema, is very difficult to differentiate from psoriasis of the palms. The dermatitis is highly irritable and painful, and is responsible for 2-5% of all applications for permanent disability in some western European countries. Treatment resistant, better response is seen to PUVA phototherapy and oral retinoids than to topical super potent steroids.
Ring Eczema of the Hands
Commonly seen in young women wearing broad rings, this type of hand eczema is caused by detergents, soaps and cosmetics under the ring. A radiation eczema caused by radioactive gold in rings can also cause similar dermatitis.
Dry Palmar Eczema (Wear and Tear Hand Dermatitis)
Also known as dry hand eczema or housewives’ dermatitis, dry hand eczema is caused by frequent exposure to water and detergents.
Fingertip Eczema
Typically involving the finger tips (palmar side) of the dominant hand, this is due to chronic exposure to occupational irritants or allergens.
Apron Eczema
This type of hand eczema involves palmar aspect of two or more fingers near to the palms and the sides of palms. This is usually caused by holding or wringing clothes immersed in detergents.
Discoid Eczema
Discoid eczema of the hands affects the back of the hands and the back or sides of individual fingers. Forearms may also be involved. The scaly plaques can occur on a previous site of burns, a local chemical or irritant reaction.
Chronic Acral Dermatitis
Commonly seen in the middle aged, a chronic, thick scaly eczema involving all or some finger tips; very resistant to topical therapy.
‘Gut’ Eczema
Also called slaughterhouse eczema, this is caused by contact with slaughterhouse animal blood, flesh and fat. Involves the finger webs and sides of fingers.
Other Types: Patchy Vesiculo-squamous Hand Eczema
A patchy hand eczema with blisters and scaling appear randomly. This hand eczema is believed to occur due to irritant contact dermatitis.
The morphological and distribution pattern of these different types of hand eczema may vary. Finding the exact cause of the hand eczema is indeed important in taking preventive and curative steps to get rid of the hand eczema.
Reference
- Contact Dermatitis, in Rook’s Textbook of Dermatology, 7th Edition, 2004
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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