Pompholyx - 水疱性皮炎
Dyshidrotic dermatitis ― 手头上的严重病例
明显的水泡并伴有严重的瘙痒。
严重时，可能会出现水疱，伴有严重瘙痒。
References
Dyshidrotic eczema ，又称急性掌跖湿疹，是成人常见的手部皮炎类型。它约占手部皮炎病例的 5-20%。这种情况的特点是手指和手掌侧面出现充满液体的小水泡，这是由皮肤外层肿胀引起的。有时，这些水泡会合并形成更大的水泡，类似于“木薯布丁”。在严重的情况下，皮疹可能会蔓延到整个手掌。诊断通常基于反复出现的皮疹的临床观察，水疱突然出现在手指上并蔓延到手掌。
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、线状水泡4天来皮肤科就诊。他最近接触过一名患有疥疮的人。该患者从小就有湿疹和哮喘病史，但成年后没有出现过任何症状。经过检查和显微镜分析，发现水泡没有任何挖洞、螨虫或虫卵的迹象。初步诊断为 pompholyx eczema ，患者开始使用温和的外用皮质类固醇。然而，患者 5 天后返回，症状恶化，并出现严重的水疱皮疹。
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、频繁洗手或金属会加重疾病。诊断通常基于其外观和症状。其他产生类似症状的疾病包括脓疱型牛皮癣和疥疮。
治疗通常使用类固醇霜。第一周或第二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
不要使用肥皂。由于手掌和足底皮肤较厚，低效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