Pompholyx - Dyshidrotic Exem
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Dyshidrotic dermatitis ― Alvarlegt mál á höndum
Svo virðist sem meinið hafi næstum batnað.
Í alvarlegum tilfellum getur það birst sem blöðrur með miklum kláða.
References
Dyshidrotic eczema , einnig þekkt sem bráða lófaplantarexem, er algeng tegund handhúðbólgu hjá fullorðnum. Það er um 5-20% tilvika handahúðbólgu. Þetta ástand einkennist af litlum vökvafylltum blöðrum á hliðum fingra og lófa, sem stafar af bólgu í ytra lagi húðarinnar. Stundum geta þessar blöðrur runnið saman til að mynda stærri, sem líkjast „tapioca pudding“. Í alvarlegum tilfellum geta útbrotin breiðst út um allan lófann. Greining er venjulega byggð á klínískri athugun á endurteknum útbrotum með blöðrum sem birtast skyndilega á fingrum og breiðast út í lófana.
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 árs gamall maður heimsótti húðsjúkdómadeildina með 4 daga sögu um ákaflega kláða, línulegar blöðrur í lófum beggja handa. Hann hafði nýlega verið í sambandi við mann sem var með kláðamaur. Sjúklingurinn hafði sögu um exem og astma frá barnæsku en hafði ekki fundið fyrir neinum köstum á fullorðinsaldri. Við athugun og smásjárgreiningu sáust blöðrur án þess að nokkur merki væru um gröf, maur eða egg. Bráðabirgðagreining pompholyx eczema var gerð og sjúklingurinn byrjaði að nota væga staðbundna barkstera. Hins vegar kom sjúklingurinn aftur 5 dögum síðar með versnandi einkenni og alvarleg blöðruútbrot.
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
Ofnæmisvaldar, líkamlegt eða andlegt álag, tíður handþvottur eða málmar eykur sjúkdóminn. Greining er venjulega byggð á því hvernig það lítur út og einkennum. Aðrar aðstæður sem valda svipuðum einkennum eru psoriasis og kláðamaur.
Meðferð er almennt með sterakremi. Þörf getur verið á sterkum sterakremum fyrstu vikuna eða tvær. Andhistamín má nota til að hjálpa við kláða.
○ Meðferð ― OTC lyf
Ekki nota sápu. Þar sem lófar og iljar eru með þykka húð, gætu lágvirk OTC sterasmyrsl ekki skilað árangri. Að taka OTC andhistamín getur einnig hjálpað.
#OTC steroid ointment
#OTC antihistamine
○ Meðferð
#High potency steroid ointment
#Alitretinoin