Eczema is the most common skin diseases : an estimated one third of consultations in dermatology town for a problem of eczema. This disease not contagious but very recurrent , is characterized by poorly demarcated redness , itchy , and by the appearance of tiny vesicles that evolve into scabs . red spots on hands Among the different types of eczema , hand eczema is the most common . Often of allergic origin , hand eczema can become very disabling.
The treatment of hand eczema is based partly on the elimination of its cause and the protection of the skin against aggression and , secondly , the administration of treatments to relieve symptoms. Hand eczema is reflected by similar signs to those of all forms of eczema. The symptoms of hand eczema The symptoms of hand eczema evolve in the four classic stages of eczema. Red and hot spots appear , more or less widespread, whose edges are ill-defined .
These highly itchy rash . A few hours after the onset of red spots , small vesicles ( the size of a pinhead ) appear , full of a clear liquid. Itching continues . Scratching lesions breaks vesicles that ooze their content.
Small yellowish crusts form , which fall within a few days . Lesions , red and smooth , cover small films ( dander) . After this episode , the lesions may temporarily disappear, recur or persist in a chronic form if the cause is still present in the environment. Gradually, damaged skin thickens and becomes darker ( lichenification ) .
Itching persist even in the absence of vesicles or seeps. We’re talking about chronic hand eczema when symptoms persist for more than six consecutive months. Complications of hand eczema Secondary infection is the most common complication of eczema. During the phase of oozing skin becomes infected (often as a result of scratching lesions ) and a purulent oozing delays healing .
Different types of hand eczema Hand eczema can have various causes that cause different symptoms ( but always according to the four classic stages of eczema ) . Eczema irritant contact is an inflammatory disease of the skin due to attacks by the environment (friction, abrasion , heat, cold , chemicals, irritating plants, etc. . ) Without an allergic process is involved .
Unlike hand eczema , dermatitis irritation does not itch . Redness with sharp edges and are limited to areas where the skin was assaulted . Dermatitis irritation weakens the skin and can promote the development of allergic contact dermatitis . The allergic contact dermatitis is a type of eczema the most common hands.
It can reach all parts of the hand to the wrist . Atopic dermatitis, a genetic predisposition to allergic reactions can result in dry skin of the palms , cracks the fingertips ( pulpitis ) or classic lesions of hand eczema. Contact dermatitis to proteins more readily found among the atopic patient. Officials proteins are of plant or animal origin.
Dyshidrosis (or pompholyx , a particular form of hand eczema ) results in itchy palms and sides of the fingers , with redness , blistering and peeling (skin ” peels “). Allergic contact dermatitis is a very common form of hand eczema. It is caused by a local allergic reaction that can be caused by many substances, there were up to 3,000 substances that can trigger an eczema of the hands. In current practice , the vast majority of contact dermatitis is due to a twenty substances ( see table).
Contact eczema often takes time to appear. Indeed, it must first reach the potential allergen to penetrate the outer barrier of the skin (the epidermis ) repeatedly , mostly by cuts , micro- abrasions, through a dry or irritated skin etc. . Once within the skin , the substance binds to certain proteins in the skin with which it forms an assembly capable of eliciting an immune response.
Gradually, certain immune cells ( T cells ) will learn to defend against this group of substances. Each exposure to the substance responsible for the allergy, the immune cells will trigger an inflammatory reaction that will cause the symptoms of eczema. Once acquired, this form of allergy is lifelong . The mechanism of occurrence of hand eczema can explain why people whose hands are regularly abused ( housewives, young mothers , manual workers , farmers , hairdressers, etc.
. ) Are most commonly affected by this form of eczema : a hand skin weakened by detergents , water , cold , sweat or chemicals will be more permeable to potential allergens . Various adjuvants plastic objects , computer accessories ( mouse, pad ) Perfumes Perfumes, cosmetics, parapharmaci Causes of atopic dermatitis Atopic dermatitis is a genetic predisposition to allergic diseases . It is a condition that can also take other forms : allergic rhinitis ( hay fever) , asthma , urticaria, allergic conjunctivitis , etc.
. It is commonly seen in children. Overall, in atopic dermatitis , the hands are relatively unaffected . However , the skin of the hands of atopic individuals is often dry and cracked , exposing them to the penetration of potentially allergenic substances , so the development of an allergic contact dermatitis .
Causes of dyshidrose are poorly understood. Links between excessive sweating and dishydrose were discussed but remain controversial . Some patients dishydrose report the occurrence of this type of eczema during periods of stress or anxiety , others closer to sun exposure in early summer. Other causes have been suggested , without proof infections caused by fungi ( mycoses ) in other parts of the body ( toes) , intestinal disorders , etc.
. How to prevent hand eczema ? For people whose work exposes the hands to various attacks ( . Chemicals, abrasion , cold, etc.
), it is important to maintain intact the outer barrier of the skin : use of gloves (possibly sub- fine cotton gloves to avoid excessive sweating, also aggressive to the skin) and regular application of emollient and protective creams (from ” dry hands ” kind ) . Similar advice applies to people who suffer from atopic dermatitis . In people who suffer from contact dermatitis , only the removal of the substance that causes allergic symptoms (the ” crowding out” ) can prevent relapse . Compliance with measures to protect the skin of the hands (such as those detailed above) also helps prevent the development of contact allergy to another substance , which a vicious circle.
Wash hands when one suffers from eczema People with hand eczema can follow some simple precautions to avoid hand washing is too aggressive : Use warm water ; do not wash your hands too often , or rubbing too hard ; Avoid soaps that contain perfumes or antibacterial agents ( disinfectants) ; dry your hands by tapping one against the other, or by placing them (do not rub ) on a towel or a soft cloth ; Avoid alcoholic disinfectant gels ( those who had their heyday during the epidemic of influenza A ) ; moisturize your hands with lotion while still slightly damp . The diagnosis of hand eczema based on the examination of the lesions, the recognition of the four typical phases of eczema and possibly microscopic examination of a skin sample . Once diagnosed, the more hard part : finding the cause of eczema, especially for contact dermatitis . For this , a proper investigation is needed.
The doctor asks about the location of the body or hand eczema which started from the date of its appearance , its evolution (eg , he disappears during the holidays ), the business environment the patient, his leisure ( sports, crafts , gardening, etc. . ) , the type of clothing worn , medications taken , bath products and cosmetics used , the existence of an allergic , etc. .
This phase is often long . When a particular type of substance is suspected, the doctor may want to carry out tests (patch tests ) to confirm the diagnosis . Various substances are applied to different areas of the back , arm or chest of the patient. Two days later , the existence and intensity of allergic reactions are sought.
These tests should be performed when the thrust of hand eczema has been controlled by treatment.