Pompholyx - Ekżema Dishidrotika
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Dyshidrotic dermatitis ― Każ sever fuq l-idejn
Jidher li l-leżjoni kważi tjiebet.
F'każijiet severi, jista 'jidher bħala folji b'ħakk sever.
relevance score : -100.0%
ReferencesDyshidrotic eczema, magħrufa wkoll bħala ekżema palmoplantar akuta (acute palmoplantar eczema), hija tip komuni ta’ dermatite tal-idejn (hand dermatitis) fl-adulti. Huwa jagħmel madwar 5‑20 % tal-każijiet ta’ dermatite tal-idejn. Din il-kundizzjoni hija kkaratterizzata minn folji żgħar mimlija fluwidu fuq il-ġnub tas‑swaba’ u l‑pali, ikkawżati minn nefħa fis‑saff ta’ barra tal‑ġilda. Xi drabi, dawn il‑folji jistgħu jingħaqdu biex jiffurmaw oħrajn akbar, li jixbħu ‘pudina tat‑tapioca’. F’każijiet severi, ir‑raxx jista’ jinfirex mal‑pala kollha tal‑id. Id‑dijanjosi hija tipikament ibbażata fuq osservazzjoni klinika ta’ raxx rikorrenti b’folji li jidhru f’daqqa fuq is‑swaba’ u jinfirxu mal‑pali.
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.
Raġel ta’ 31 sena żar id-dipartiment tad‑dermatoloġija b’storja ta’ 4 ijiem ta’ rash vesicular lineari (linear vesicular rash) u b’ħaxx intens fuq il-pali taż-żewġ idejn. Dan l-aħħar kien f’kuntatt ma’ persuna li kellha l‑iskabbia. Il‑pazjent kellu storja ta’ ekżema u asthma sa mit‑tfulija iżda ma esperjenza l‑ebda flare‑ups fi żmien adult. Mal‑eżami u l‑analiżi mikroskopika, nfafet ġew osservati mingħajr l‑ebda sinjali ta’ tħaffir, dud, jew bajd. Saret dijanjosi preliminari ta’ pompholyx eczema, u l‑pazjent beda juża kortikosterojdi topiċi ħfief. Madankollu, il‑pazjent re‑presentat 5 ijiem wara b’sintomi li jmorru għall‑agħar u rash vesico‑bullous sever (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
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
Allerġeni, stress fiżiku jew mentali, ħasil frekwenti tal-idejn, jew metalli jaggravaw il-marda. Id-dijagnosi hija tipikament ibbażata fuq kif tidher u s-sintomi. Kundizzjonijiet oħra li jipproduċu sintomi simili jinkludu psorjasi pustulari u scabies.
It-trattament huwa ġeneralment bi krema sterojda. Kremi sterojda ta’ qawwa għolja jistgħu jkunu meħtieġa għall-ewwel ġimgħa jew tnejn. Jistgħu jintużaw anti‑istaminiċi biex jgħinu bil‑ħakk.
○ Trattament - Drogi OTC
Tużax sapun. Peress li l-pali u l-qigħan għandhom ġilda ħoxna, l‑ingwenti sterojda OTC ta’ qawwa baxxa jistgħu ma jkunux effettivi. It‑teħid ta’ antistaminiku OTC jista’ jgħin ukoll.
ointment sterojdi OTC (OTC steroid ointment)
antistaminiku OTC (OTC antihistamine)
○ Trattament
ointment sterojdi b’potenzja għolja (High potency steroid ointment)
Alitretinoin