Pompholyx - Dishidrotski Ekcem
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Dyshidrotic dermatitis ― Ozbiljan slučaj u rukama
Čini se da se lezija gotovo popravila.
U teškim slučajevima može se pojaviti kao mjehurići s jakim svrbežom.
References
Dyshidrotic eczema , poznat i kao akutni palmoplantarni ekcem, čest je tip dermatitisa šaka kod odraslih. Čini oko 5-20% slučajeva dermatitisa ruku. Ovo stanje karakteriziraju mali mjehurići ispunjeni tekućinom na stranama prstiju i dlanova, uzrokovani oticanjem vanjskog sloja kože. Ponekad se ti mjehurići mogu spojiti i formirati veće, nalik 'pudingu od tapioke'. U teškim slučajevima, osip se može proširiti preko cijelog dlana. Dijagnoza se obično temelji na kliničkom promatranju ponavljajućeg osipa s mjehurićima koji se iznenada pojavljuju na prstima i šire na dlanove.
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.
31-godišnji muškarac posjetio je dermatološki odjel s 4-dnevnom poviješću intenzivnog svrbeža, linearnih mjehurića na dlanovima obje ruke. Nedavno je bio u kontaktu s osobom koja je imala šugu. Pacijent je imao povijest ekcema i astme od djetinjstva, ali nije doživio nikakve napade u odrasloj dobi. Nakon pregleda i mikroskopske analize uočeni su mjehurići bez ikakvih znakova bušenja, grinja ili jaja. Postavljena je preliminarna dijagnoza pompholyx eczema , a pacijent je počeo koristiti blage lokalne kortikosteroide. Međutim, pacijent se vratio 5 dana kasnije s pogoršanjem simptoma i teškim osipom s mjehurićima.
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
Alergeni, fizički ili psihički stres, često pranje ruku ili metali pogoršavaju bolest. Dijagnoza se obično temelji na tome kako izgleda i simptomima. Ostala stanja koja proizvode slične simptome uključuju pustularnu psorijazu i šugu.
Liječenje se općenito provodi steroidnom kremom. Prvih tjedan ili dva mogu biti potrebne steroidne kreme visoke jačine. Za ublažavanje svrbeža mogu se koristiti antihistaminici.
○ Liječenje ― OTC lijekovi
Nemojte koristiti sapun. Budući da dlanovi i tabani imaju debelu kožu, OTC steroidne masti niske potencije možda neće biti učinkovite. Uzimanje OTC antihistaminika također može pomoći.
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