KOCHI: Eczema is a clinical and histological pattern of inflammation of the skin, seen in a variety of dermatoses, with widely diverse aetiologies. The terms dermatitis and eczema are generally synonymous, although some authors still use the term dermatitis to include all types of cutaneous inflammation. So all eczemas are dermatitis, but not all dermatitis is eczema.
Hand dermatitis (hand eczema) is a condition where dermatitis is largely confined to the hands with minor involvement of other areas. It is a common condition that affects one in every 20 people. It begins during childhood as part of an in-built tendency to eczema but is most common among working-age adults. Hand dermatitis may be a short-lived, mild problem. But in some people, it can last for many years in a severe form and impact their daily life, often restricting their ability to work.
Is it hereditary?
No, it is not hereditary. The vulnerability to hand dermatitis can run in families along with childhood eczema, asthma and hay fever.
Symptoms
Hot, sore, rough, scaly and itchy skin, itchy blisters or painful cracks
What does it look like?
The skin looks inflamed, red and swollen, with a damaged dried out surface which makes it look flaky. There may be cracked areas that bleed and ooze. Sometimes small vesicles can be seen on the palms or sides of the fingers. Different parts of the hand can be affected, including the finger webs, fleshy finger pulps or centre of the palms. Hand dermatitis may get infected with bacteria like Staphylococcus or Streptococcus. This causes more redness, soreness, crusting, oozing and spots or pimples.
Diagnosis
Hand dermatitis is diagnosed by carefully examining the skin.
Patch tests help detect the causative allergen.
Prevention
Hands are the point of contact for many irritants such as soaps and detergents. Frequent contact with irritants, including water in excessive amounts, reduces skin barrier function and can promote the development of hand eczema or trigger preexisting hand eczema. Taking good care of your hands will help repair the skin barrier and reduce inflammation. This will not cure the condition and may resurface if hands are not cared for properly. Wearing protective cotton-lined gloves at work, using barrier creams and soap substitutes like Syndet bars and avoiding contact with allergens can help improve the situation.
Who is vulnerable?
*People with a history of eczema in childhood (atopic eczema)
*Those who work in jobs with frequent water contact, like cleaners, people who look after young children, chefs, hairdressers, mechanics, surgeons, dentists, nurses, florists etc.
Causes of hand dermatitis?
This condition can have both external and internal causes.
External irritants include: Chemical (e.g. soap, detergents, solvents)
Physical (friction, minor trauma, cold dry air)
Contact allergens: Delayed hypersensitivity (type IV) (chromium, rubber)
Immediate hypersensitivity (type I) (e.g. seafood)
Ingested allergens (drugs, possibly nickel, chromium)
Infection (following bacterial infection of hand wounds)
Secondary dissemination (dermatophyte reaction to Athlete’s foot)