Pompholyx - 水疱症
Dyshidrotic dermatitis ― 手頭上的嚴重病例
明顯的水泡並伴隨嚴重的搔癢。
嚴重時，可能會出現水皰，伴隨嚴重搔癢。
References
Dyshidrotic eczema ，又稱急性掌蹠濕疹，是成人常見的手部皮膚炎類型。它約佔手部皮膚炎病例的 5-20%。這種情況的特徵是手指和手掌側面出現充滿液體的小水泡，這是由皮膚外層腫脹引起的。有時，這些水泡會合併形成更大的水泡，類似於「木薯布丁」。在嚴重的情況下，皮疹可能會蔓延到整個手掌。診斷通常基於反覆出現的皮疹的臨床觀察，水皰突然出現在手指上並蔓延到手掌。
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歲男性因雙手手掌出現劇烈搔癢、線狀水泡4天來皮膚科就診。他最近接觸過一名患有疥瘡的人。該患者從小就有濕疹和氣喘病史，但成年後沒有出現任何症狀。經過檢查和顯微鏡分析，發現水泡沒有任何挖洞、蟎蟲或蟲卵的跡象。初步診斷為 pompholyx eczema ，患者開始使用溫和的外用皮質類固醇。然而，患者 5 天後返回，症狀惡化，並出現嚴重的水皰皮疹。
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
過敏原、身體或精神壓力、頻繁洗手或金屬會加重疾病。診斷通常基於其外觀和症狀。其他產生類似症狀的疾病包括膿皰型牛皮癬和疥瘡。
治療通常使用類固醇乳霜。第一周或第二週可能需要使用高強度類固醇乳霜。抗組織胺可用於緩解搔癢。
○ 治療 - 非處方藥
不要使用肥皂。由於手掌和足底皮膚較厚，低效非處方類固醇軟膏可能無效。服用非處方抗組織胺也有幫助。
#OTC steroid ointment
#OTC antihistamine
○ 治療
#High potency steroid ointment
#Alitretinoin