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How do you manage patients with hand dermatitis recalcitrant to potent topical steroids?
Answer from: at Academic Institution
Strictly dorsal/interdigital = irritant contact derm
Purely palmar = atopic (should not be using the term "dyshidrosis" any longer
Both palmar and dorsal = allergic contact derm
If irritant, most important things, according to data from Covid, are:
Washing hands in cold water
Avoiding soa...
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Answer from: at Academic Institution
Agree, with the caveat that alcohol-based hand sanitizers are less irritating than water (e.g. wet work or perspiration) in the winter season. That’s why the cotton under occlusive gloves are so important.
Also, topical steroids are contraindicated in chronic irritant dermatitis. Thinning the...
Answer from: at Community Practice
The first step is to try and identify the cause of the hand dermatitis as well as the type. Eczematous? Allergic or Irritant Contact? Occupational?
A biopsy and evaluation of the nails and other skin areas can be helpful if psoriasis or other auto-inflammatory or auto-immune conditions are the prim...
Answer from: at Community Practice
I agree with Dr. @Kwak and Dr. @Nedorost. If it's irritant dermatitis, then you're going to get more benefit from educating the patient on skincare recs than topical steroids. Soap is the main culprit for most of these people in my experience. One specific thing I tell patients is to be aware of whe...