Vesicular Hand Dermatitis
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This disorder is a severely pruritic reaction in individuals with a personal or family history of allergic manifestations. It is characterized by flares of congestion resulting in deep and superficial blisters, followed by peeling, scaling, and a dry, reddened surface. Flares generally result from contact with irritants, but stress is also a significant factor.
Clinical presentation Of Vesicular Hand Dermatitis
The severity of vesicular palmoplantar eczema symptoms varies, ranging from mild discomfort to acute severe episodes. Patients rarely require hospitalization.
- Classically, itching, burning, and prickling sensations of the palms and soles precede the eruption of vesicles.
- Thereafter, small (1- to 2-mm) vesicles form, most commonly on the lateral sides of the fingers. In pompholyx, the central areas of the palms and soles may or may not be involved.
- Large vesicles can develop on the palms and soles and may coalesce to form confluent bullae.
- The lesions last for 2-3 weeks, after which spontaneous resolution generally occurs. Occasionally, large bullae may need to be aspirated. This phase is followed by desquamation.
- Chronic forms typically recur, and episodes are more frequent during the spring and summer than in the fall and winter.
- The chronic hyperkeratotic variety results in severe itching accompanied by thickening and fissuring of the palm. This effect may decrease the mobility of the affected hand.
Causes of Vesicular Hand Dermatitis
The etiology of hand eczema is unknown, but most observers suggest that intrinsic changes in the skin are responsible for vesicular palmoplantar eczema. A study of an autosomal dominant form of pompholyx found a genetic linkage on chromosome 18. Whether other forms have a similar genetic linkage is not clear. However, several exogenous factors have been implicated in the causation or worsening of vesicular palmoplantar eczema
Treatment of Vesicular Hand Dermatitis
Several modalities of therapy are available for the treatment and control of vesicular palmoplantar eczema. Therapy should be chosen according to the type and severity of the condition. Whenever possible, eliminate known triggers. If pruritus is a problem, antihistamines (eg. hydroxyzine) can relieve some symptoms.
Source by medscape
Another presentation of Vesicular Hand Dermatitis :
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