Hand eczema is a skin disease characterized by symptoms such as dryness, redness, itching, dandruff on the hands or blisters filled with water and watering. It occurs in both sexes, but is more common in women. Housewives, construction workers, health personnel, hairdressers, dental technicians, workers working in the bakery constitute the high-risk group for hand eczema.
CAUSES OF HAND ECZEMA
There are many clinical subtypes of hand eczema. The causes of eczema vary according to clinical types. The most common chronic irritant eczema develops due to excessive contact with water, soap, detergent, various solvent chemicals, cement, and prolonged contact with substances such as rubber gloves. Chronic exposure to these substances leads to impaired barrier function of the skin. Apart from these, personal predisposition, sun exposure, stress and seasonal factors can trigger different types of eczema. Sometimes, the cause of eczema cannot be found.
SYMPTOMS OF HAND ECZEMA
The disease gives different symptoms in acute and chronic periods. In acute eczema, redness on the hands, blisters filled with water, and irrigation are seen, while in chronic eczema, changes such as dryness, redness, cracking, and flaking are observed in the skin. There are different clinical subtypes according to the causes of hand eczema.
1-Atopic Eczema: It is personally associated with allergic susceptibility. It is seen in the form of dryness, redness and itching on the hands, especially in cold and dry weather.
2-Dyshidrotic Eczema: It is often seen as pinhead-sized blisters. It can develop by contact with some allergens or ingestion. It may show seasonal features.
3-Numular Eczema : Usually coin-sized, oval or round, reddened, scaly plaques are seen on the hands. The cause is often not found. It can be triggered by many factors such as dry skin, stress, allergens.
4-Allergic Contact Eczema:There are red, raised, itchy lesions that develop after contact with substances such as some metals, plastics, cosmetic products, chemicals.
5-Irritant Contact Eczema: It occurs when substances such as soap, detergent, and solvents cause direct damage to the skin. Shows signs of chronic eczema.
6-Photosensitive Eczema:In people who are sensitive to the sun, it may develop after direct exposure to sunlight or after sun exposure after some local or oral medications.
7-Neurodermatitis:It is eczema caused by chronic scratching due to stress.
DIAGNOSIS OF HAND ECZEMA
The diagnosis of eczema is often made with the physical examination findings of the patient. If it is thought to be triggered by external factors, patch tests can be done to determine the cause. If necessary, a skin biopsy is taken to confirm the diagnosis.
TREATMENT OF HAND ECZEMA
The main treatment in eczema is to avoid the factors that cause eczema. Protective gloves should be used in cases where contact with these factors is required. Good hydration should be provided to maintain the barrier function of the hands. In most patients, local treatment is sufficient to control the disease. While wet dressings and drying creams are preferred in the acute period, oily ointments are used in chronic eczema and skin-thinning creams are used in cases of thickening of the skin.
Local Corticosteroids: It is the first choice treatment for eczema. They suppress itching and redness of the skin. It can thin the skin in long-term use.
Local Calcineurin Inhibitors: Local Tacrolimus and Pimecrolimus can be used in hand eczema. They do not thin the skin like corticosteroids. There may be some side effects in long-term use.
Local Phototherapy: It can be applied in the form of UVB, narrowband UVB, PUVA. It is applied as 2 or 3 sessions per week.
Systemic Corticosteroids: They are used for a short time in cases where the disease is severe. As the disease improves, the dose of the drug is reduced and discontinued by the doctor.
Antihistamines:They are used to control itching.
Other Treatments: Deterioration of skin integrity in patients increases the risk of infection. Local or systemic antibiotics are used in case of infection.
COURSE OF HAND ECZEMA
Hand eczema regresses easily when care is taken to protect it and regular treatment is applied, but when avoidance of the causative factors is not fully achieved, it shows a chronic course with recovery and relapses.
