Eczema:
Eczema originates from the ancient Greek word "ekzein". The word meaning is defined as swelling, foaming and refers to the edema and watering in eczema.
Eczema can be seen anywhere in the body. However, it affects the areas of the skin that are most dry and exposed to trauma, namely the hands.
Hand eczema, which is more common in women than men, is a problem that reduces the standard of living if left untreated. . For this reason, the skin must be moisturized very well in order to prevent possible attacks.
Clinically, there are 7 different types of hand eczema and their frequency of occurrence varies. However, the most common are the “housewife type” eczemas, which are defined as chronic irritant hand eczemas.
CHRONIC IRRITANT HAND ECCEMA
More "Chronic irritant hand eczema", which affects many housewives, is, as the name suggests, a toxic reaction. Many factors play a role in the formation of chronic irritant hand eczema. In housewives, contact with excessive water, detergent and other irritating substances is usually the most important factor in the formation of these eczemas. Chronic exposure to these agents and physical traumas play an important role in the formation of irritant hand eczema.
In addition, hairdressers, dental technicians, butchers, construction workers, nurses, painters and healthcare personnel also constitute the population at risk for hand eczema. . This type of eczema usually manifests itself as a pattern that starts between the fingers and spreads towards the upper parts of the hand and the palms. The lesions do not have the same severity on both hands. Generally, the dominant hand is more affected.
Clinically, acute changes such as redness and fluid collection on the hands or chronic changes such as cracking and flaking of the skin are observed.
In addition, inflammation around the nail on the fingers with severe eczema, commonly known as 'entanglement', can cause damage to the nail bed and cause nail deterioration.
Hand eczema tends to recur. Generally, recurrent atopy is a type called ichthyosis. It occurs in people with skin diseases, dry skin, and old age. It is very important to distinguish chronic irritant hand eczema from allergic contact dermatitis, psoriasis and fungal infections. Patch test is used in the differential diagnosis of allergic contact dermatitis.
Treatment: The most important factor in treatment is to avoid irritating substances. In addition, using skin protective creams and gloves is also very important in treatment. Care should be taken to use gloves that do not contain potassium dichromate or thiuram, as sometimes the gloves themselves can cause allergies. In the acute period, topical corticosteroid creams and wet dressings can be used, and oral antihistamine medications can be used in patients with very severe itching. In the chronic period when crusting and cracking on the hands are observed, emollients with a barrier effect and corticosteroid pomades should be preferred. Systemic short-term corticosteroids can be given in very severe patients.
HYPERKERATOSIC HAND ECZEMAS;
Regarding the formation of these eczemas, the cause of which is not fully known. There are two theories. The first is a genetic predisposition, the other is an exaggerated response to recurrent hand eczema. In other words, irritant contact dermatitis recurs many times and the patient's condition turns into hyperkeratotic eczema. Exposure to allergic substances or occupational causes do not play a role in these eczemas.
Hyperkeratotic eczema manifests itself with small, sharply defined, thickened, inflamed plaques covered with crusts on the inner surface of the hands. In some cases, cracks and flaking may occur on the skin.
Treatment:
These eczemas, which are chronic and tend to recur, are difficult to treat. First of all, it is very important to make a differential diagnosis from fungal infections and some chronic skin conditions (such as psoriasis). In severe cases, systemic treatment is recommended. In topical treatment, it is important to remove flaking with peeling creams in the first stage. In the second stage, high and medium effective cortisone pomades are used until the redness and eczema disappear. ar should be used. Additionally, tar creams or topical vitamin D options can also give positive results. Local PUVA can also be applied in resistant patients.
DYSHYDROTIC HAND ECZEMA
Dyshidrotic hands appear as very itchy, small blisters on the hands. Eczema usually occurs in young and middle ages. The condition tends to occur more frequently during the summer months. “A person's allergy is a risk factor for the occurrence of dyshidrotic eczema in the future. Many factors play a role in the formation of dyshidrotic eczema.
One of these is the allergic reactions caused by the fungal infection in the feet, which we call id reaction. If these people have a fungal infection in the feet, these reactions may occur in their hands. Systemic ingestion of the allergen can also cause dyshidrotic eczema. For example, in some patients with nickel allergy, taking nickel orally can trigger dyshidrotic eczema on the hands. In addition, some drug reactions and smoking can also cause dyshidrosis. In some patients, an underlying cause may not be found. In this case, it is necessary to focus on stress and emotional factors. These patients may experience attacks especially in spring, autumn and summer.
It most commonly starts from the lateral parts of the 2nd and 4th fingers on the hands. In dyshidrotic eczema, the thumb is usually not affected. Sometimes, fine peeling may occur in the areas where blisters form on the inside of the hands. This eczema, which is a different form of dyshidrotic eczema, occurs in atopic people, especially in the summer months.
>
sp;
Treatment:
In the differential diagnosis of dyshidrotic eczema,allergic contact dermatitis may be considered and a patch should be applied to the patient. Rarely, fungal infections on the hands may occur in the form of dyshidrotic eczema.
Treatment can be done systemically or topically depending on the severity of eczema. In mild cases, high-potency cortisone creams should be applied topically. If the blisters on the patient's hands are large, a dressing called wet dressing can be applied. In patients with severe symptoms, short-term corticosteroids can be used systemically for 10-20 days. If infection is suspected, oral antibiotic treatment may be necessary.
RING ECCEMA:
Ring eczema is also more common in women. It is a type of eczema. It is thought to develop due to trauma along with soap and detergent accumulated under the ring. In ring eczema, the condition starts from the bottom of the ring and spreads to neighboring areas.
Treatment:
Local cortisone pomades are used in treatment.
Read: 0
