Pompholyx - 水疱性皮炎
Dyshidrotic dermatitis ― 手头的严重病例
出现明显的水泡，并伴有严重的瘙痒。
严重时，可能出现水疱，并伴有强烈瘙痒。
relevance score : -100.0%
ReferencesDyshidrotic eczema（急性掌跖湿疹）是成人常见的手部皮炎类型，约占手部皮炎病例的5%–20%。其特点是手指和手掌侧面出现充满液体的小水泡，因皮肤表层肿胀而形成。有时这些水泡会合并成更大的水泡，形似“木薯布丁”。在严重情况下，皮疹可蔓延至整个手掌。诊断主要依据临床表现，即反复出现的皮疹，水泡突然出现在手指并向手掌扩展。
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.
一名31岁男性因双手手掌出现剧烈瘙痒和线状水泡，病程4天，前来皮肤科就诊。近期曾接触一名患有疥疮的患者。该患者自幼有湿疹和哮喘史，但成年后未出现症状。经检查及显微镜分析，水泡未见挖洞、螨虫或虫卵。初步诊断为 pompholyx eczema，随后使用温和的外用皮质类固醇。5天后患者复诊，症状加重，出现严重的水疱性皮疹。
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
过敏原、身体或精神压力、频繁洗手以及金属接触均可加重病情。诊断主要依据临床表现。需与脓疱型牛皮癣、疥疮等可出现类似症状的疾病鉴别。
治疗首选局部类固醇霜。首1–2周可能需要使用高强度类固醇霜。抗组胺药可用于缓解瘙痒。
○ 治疗 - 非处方药
避免使用肥皂。由于手掌和足底皮肤较厚，低效的非处方类固醇软膏可能无效。服用非处方抗组胺药也有帮助。
#OTC steroid ointment
#OTC antihistamine
○ 治疗
#High potency steroid ointment
#Alitretinoin