The hands are one of the parts of the body that we use the most in our daily activities, especially those people who work regularly handling chemicals, latex gloves, harmful substances or tools; in which cases their hands are not properly protected; so the occupation of the individual plays an important role in the appearance of dermatitis in the hands.
The hand dermatitis is a common condition often chronic and recurring in time and which is caused by multiple causes, manifesting different types lesions palm and back of the hand.
It is estimated that 10 out of 100 people have an episode of this condition throughout their lives, so when this problem recurs, it is necessary to see a doctor to make a correct diagnosis and recommend timely treatment in order to prevent complications.
Types of lesions caused by dermatitis on the hands
The hand dermatitis may manifest from a simple redness of the skin through swelling, itching, burning and pain, reaching injury type pustules and vesicles that can be descamar. When it becomes recurrent, the lesions tend to be thicker, cracked, and change the color of the hands.
Classification and causes of dermatitis on the hands
According to its cause, it is classified as:
1. Irritant contact dermatitis
It is the most common dermatitis on the hands, it occurs in approximately 35% of patients due to direct contact with an irritating substance or constant hand washing.
It can be evidenced in people with an occupation related to cleaning, medicine, dentistry and food handlers due to the constant hygiene on their hands. It is also evidenced in hairdressers, laborers, engineers, etc.
2. Allergic contact dermatitis:
It is due to a local allergic reaction that occurs every time the hands contact objects or irritants that induce an allergic reaction.
Generally, it occurs on the tips of the fingers and on the back of the hands, in the form of pustules that cause itching and scaling.
3. Atopic dermatitis
It is an inflammatory state of the hands, related to a generalized allergic state. The Atopic dermatitis occurs in children and adults, who often have other allergic conditions such as asthma, rhinitis and allergies to medications. It manifests as dry skin, thickening of the skin, and peeling.
4. Hyperkeratotic dermatitis on the palms (DHP)
It is characterized by the presence of painful plaques and fissures in the palms of the hands, generally related to heavy work (mechanics, workers, etc.). It is usually stable and chronic.
5. Nummular dermatitis
Numular, which comes from the word currency, is the name given to the type of dermatitis on the hands that is expressed with scaly lesions in a circular, oval or coin shape.
6. Dyshidrotic dermatysis
It is characterized by the appearance of small papules and vesicles on the sides of the fingers, which can be painful but do not itch and are triggered by excessive sweating of the hands or contact with some chemical agents. Lesions tend to peel and are self-limited, appearing recurrently.
7. Friction dermatitis
It is characterized by the appearance of pustular, reddened and scaly lesions, due to constant friction during the manipulation of certain objects such as coins, bills, paper, etc.
Treatment of dermatitis on the hands
Treatment is generally similar for all types of hand dermatitis. It is suggested to prevent all triggers such as the use of chemicals and irritants or to properly protect your hands.
A person scratching their hands with the presence of sores and redness due to atopic dermatitis
1. Improve lifestyles
The use of moisturizing creams is recommended, avoiding unnecessary hand washing and substituting substances that trigger allergies with less harmful ones. During hand washing it is recommended to avoid soaps with dyes and fragrances. Do it with warm water and soaps with a neutral pH.
2. Cream treatments
The first therapeutic option for any type of dermatitis in the hands, except hyperkeratotic, is the use of topical steroids. These should be applied twice a day for 15 days and then twice a day for a month. It is important not to abuse steroids, because they can worsen dermatitis if the patient develops hypersensitivity to its components.
It is worth noting that there are other treatments such as tacrolimus or bexarotene, used by dermatologists for the treatment of dermatitis on the hands.
Botulinum toxin is used to control excess sweating on the hands that causes dyshidrotic dermatitis.
4. Ultraviolet radiation
This has been used as an adjunctive treatment by some dermatologists.
5. Oral treatment
It is intended for severe cases. Medications such as prednisone, methotrexate and cyclosporine A are used, which must be used with caution due to their possible adverse effects.
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