Hand and foot eczema, hyperkeratotic-rhagadiformes L24.9

Author: Prof. Dr. med. Peter Altmeyer

Co-Autor: Gulmira Stoll

All authors of this article

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch

Synonym(s)

chronic dermatitis of the hands; chronic foot eczema; chronic hand and foot eczema; chronic hand eczema; Eczema Callus dermatitis; Eczema tylose; Eczema tylotic; hand and foot eczema; hyperkeratotic rhagadiform hand eczema; irritant hand dermatitis, hyperkeratotic hand eczema; tyotic hand eczema

Definition
This section has been translated automatically.

Non-prejudicial description for a chronic eczema of different aetiology on hands and feet.

Etiopathogenesis
This section has been translated automatically.

Causes may include cumulative toxic hand eczema/foot eczema, contact allergic eczema, atopic eczema and psoriasis palmaris et plantaris. S.a.u. occupational dermatoses.

Clinical features
This section has been translated automatically.

Hyperkeratotic rhagadiform eczema of the hands and feet is a chronic or chronically recurrent eczema that can affect the hands, fingers, interdigits and back of the hand. It shows a colourful picture with itching, extensive redness, interspersed fine blisters, papules and hyperkeratotic plaques as well as mostly diffuse coarse lamellar scaling. On the flexor side of the wrist, the eczematous changes are blurred (important DD to psoriasis palmaris) and can spread to the forearm flexor side. Erosions and rhagades are also observed.

Diagnosis
This section has been translated automatically.

To be clarified is an atopic diathesis (atopic hand/foot eczema), a contact sensitization (if necessary occupational disease), a psoriasis palmaris/plantaris like a tinea palmaris/plantaris. If these diseases are excluded, the descriptive diagnosis "hyperkeratotic rhagadiform eczema of the hands and feet" can be named as the exclusion diagnosis.

Therapy
This section has been translated automatically.

If necessary, avoid the triggering noxious agent. Initially medium to strong glucocorticoid in a fatty base such as 0.1% mometasone ointment (e.g. Ecural Fatty Ointment) or 0.05% clobetasol ointment (e.g. Dermoxin Ointment) possibly under an occlusive dressing for 12 hours. Possibly 2-10% salicylic acid-containing ointments. Consecutive ointments containing tar R229. Avoidance of mechanical skin stress. Local PUVA bath therapy (see below eczema) can be tried. Alitretinoin was specifically approved in Germany in 2008 for the treatment of severe chronic hand eczema that does not respond to potent topical corticosteroids.

Literature
This section has been translated automatically.

  1. Schwensen JF et al (2014) The combined diagnosis of allergic and irritant contact dermatitis in a retrospective cohort of 1000 consecutive patients with occupational contact dermatitis. Contact dermatitis 71:356-363

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020