Pompholyx - Dihidrotični Ekcem
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Dyshidrotic dermatitis ― Hud primer na dlani
Zdi se, da se je lezija skoraj izboljšala.
V hujših primerih se lahko pojavi kot mehurji z močnim srbenjem.
References
Dyshidrotic eczema , znan tudi kot akutni palmoplantarni ekcem, je pogost tip dermatitisa rok pri odraslih. Predstavlja približno 5-20% primerov dermatitisa rok. Za to stanje so značilni majhni s tekočino napolnjeni mehurčki na straneh prstov in dlani, ki jih povzroči otekanje zunanje plasti kože. Včasih se lahko ti mehurji združijo in tvorijo večje, ki spominjajo na tapiokin puding. V hujših primerih se lahko izpuščaj razširi po celotni dlani. Diagnoza običajno temelji na kliničnem opazovanju ponavljajočega se izpuščaja z mehurčki, ki se nenadoma pojavijo na prstih in se razširijo na dlani.
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-letni moški je obiskal dermatološki oddelek s 4-dnevno zgodovino močno srbečih linearnih mehurjev na dlaneh obeh rok. Pred kratkim je bil v stiku z osebo, ki je imela garje. Bolnik je imel ekcem in astmo v anamnezi že od otroštva, vendar v odrasli dobi ni doživel nobenih izbruhov. Po pregledu in mikroskopski analizi so bili opaženi mehurji brez kakršnih koli znakov vkopavanja, pršic ali jajčec. Postavljena je bila predhodna diagnoza pompholyx eczema in bolnik je začel uporabljati blage lokalne kortikosteroide. Vendar pa se je bolnik 5 dni pozneje vrnil s poslabšanjem simptomov in hudim mehurjastim izpuščajem.
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, telesni ali psihični stres, pogosto umivanje rok ali kovine poslabšajo bolezen. Diagnoza običajno temelji na videzu in simptomih. Druga stanja, ki povzročajo podobne simptome, vključujejo pustularno psoriazo in garje.
Zdravljenje je običajno s steroidno kremo. Prvi teden ali dva bodo morda potrebne steroidne kreme visoke jakosti. Za lajšanje srbenja se lahko uporabljajo antihistaminiki.
○ Zdravljenje ― OTC zdravila
Ne uporabljajte mila. Ker imajo dlani in podplati debelo kožo, nizkoučinkovita OTC steroidna mazila morda ne bodo učinkovita. Pomaga lahko tudi jemanje antihistaminika brez recepta.
#OTC steroid ointment
#OTC antihistamine
○ Zdravljenje
#High potency steroid ointment
#Alitretinoin