Pompholyx - Eczema Dishidrótico
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Dyshidrotic dermatitis ― Un caso grave nas mans
Parece que a lesión case mellorou.
En casos graves, pode aparecer como burbullas con comezón forte.
References
Dyshidrotic eczema , tamén coñecido como eczema palmoplantar agudo, é un tipo común de dermatite das mans nos adultos. Constitúe un 5-20% dos casos de dermatite das mans. Esta condición caracterízase por pequenas burbullas cheas de líquido nos lados dos dedos e das palmas das mans, causadas polo inchazo da capa externa da pel. Ás veces, estas burbullas poden fundirse para formar outras máis grandes, que se asemellan ao pudim de tapioca. En casos graves, a erupción pode estenderse por toda a palma da man. O diagnóstico normalmente baséase na observación clínica dunha erupción recorrente con burbullas que aparecen de súpeto nos dedos e que se espallan ás palmas das mans.
Dyshidrotic eczema (DE) or acute palmoplantar eczema is a common cause of hand dermatitis in adults. It accounts for 5-20% of the causes of DE. It is a vesiculobullous disorder of the hands and soles. It is an intraepidermal spongiosis of the thick epidermis in which accumulation of edema causes the formation of small, tense, clear, fluid-filled vesicles on the lateral aspects of the fingers that can become large and form bullae. The vesicles can have a deep-seated appearance, which is referred to as “tapioca pudding.” In severe cases, lesions can extend to the palmar area and affect the entire palmar aspect of the hand. The diagnosis is mostly clinical and suggested by a recurrent rash of acute onset with vesicles and bullae located in the fingers extending to the palmar surfaces of the hands.
Dyshidrotic eczema (DE) or acute palmoplantar eczema is a common cause of hand dermatitis in adults. It accounts for 5-20% of the causes of DE. It is a vesiculobullous disorder of the hands and soles. It is an intraepidermal spongiosis of the thick epidermis in which accumulation of edema causes the formation of small, tense, clear, fluid-filled vesicles on the lateral aspects of the fingers that can become large and form bullae. The vesicles can have a deep-seated appearance, which is referred to as “tapioca pudding.” In severe cases, lesions can extend to the palmar area and affect the entire palmar aspect of the hand. The diagnosis is mostly clinical and suggested by a recurrent rash of acute onset with vesicles and bullae located in the fingers extending to the palmar surfaces of the hands.
Un home de 31 anos visitou o departamento de dermatoloxía cun historial de 4 días de burbullas lineais e intensamente picantes nas palmas das dúas mans. Recentemente estivera en contacto cunha persoa que tiña sarna. O paciente tiña antecedentes de eccema e asma desde a infancia, pero non experimentara ningún brote na idade adulta. Tras o exame e a análise microscópica, observáronse burbullas sen signos de excavación, ácaros ou ovos. Fíxose un diagnóstico preliminar de pompholyx eczema e o paciente comezou a usar corticoides tópicos leves. Non obstante, o paciente volveu 5 días despois con empeoramento dos síntomas e unha grave erupción cutánea.
A 31-year-old man presented to dermatology with a 4 day history of an intensely itchy, linear, vesicular rash affecting the palms of both hands, on the background of recent exposure to a patient with scabies. The patient had a history of childhood eczema and asthma but no exacerbations in adulthood. Examination and microscopy revealed a vesicular rash with an absence of any burrows, mites or eggs. A provisional diagnosis of pompholyx eczema was made and the patient was commenced on mild topical corticosteroids. The patient re-presented 5 days later with worsening symptoms and a severe vesico-bullous rash
A 31-year-old man presented to dermatology with a 4 day history of an intensely itchy, linear, vesicular rash affecting the palms of both hands, on the background of recent exposure to a patient with scabies. The patient had a history of childhood eczema and asthma but no exacerbations in adulthood. Examination and microscopy revealed a vesicular rash with an absence of any burrows, mites or eggs. A provisional diagnosis of pompholyx eczema was made and the patient was commenced on mild topical corticosteroids. The patient re-presented 5 days later with worsening symptoms and a severe vesico-bullous rash
Os alérxenos, o estrés físico ou mental, o lavado frecuente de mans ou os metais agravan a enfermidade. O diagnóstico normalmente baséase no seu aspecto e nos síntomas. Outras condicións que producen síntomas similares inclúen a psoríase pustulosa e a sarna.
O tratamento é xeralmente con crema de esteroides. As cremas de esteroides de alta resistencia poden ser necesarias durante a primeira semana ou dúas. Pódense usar antihistamínicos para axudar a coceira.
○ Tratamento - Medicamentos OTC
Non use xabón. Dado que as palmas e as plantas teñen unha pel grosa, as pomadas de esteroides OTC de baixa potencia poden non ser eficaces. Tomar un antihistamínico OTC tamén pode axudar.
#OTC steroid ointment
#OTC antihistamine
○ Tratamento
#High potency steroid ointment
#Alitretinoin