Causes of Hand eczema
List of causes of Hand eczema
Following is a list of causes or underlying conditions
(see also Misdiagnosis of underlying causes of Hand eczema)
that could possibly cause Hand eczema includes:
- Overexposure to skin irritant
- Allergic reaction
- Contact with allergen
- Hand dermatitis is particularly prevalent in occupations such as:
- Catering
- Metalworking
- Hairdressing
- Cleaning
- Healthcare - due to frequent hand washing
- Mechanical work
Hand eczema Causes: Book Excerpts
Related information on causes of Hand eczema:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Hand eczema may be found in:
Causes of Hand eczema: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the causes of Hand eczema.
Hand and Foot Rashes:
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Dyshidrotic eczema (pompholyx)
–Very common idiopathic skin disease
–Affects one or both hands and/or feet in the
thenar eminence, palms and/or soles, and sides of fingers and toes
–Causes itching, scaling, and erythema, and minute vesicles and painful fissures
–Usually chronic and intermittent, and often exquisitely pruritic
- Irritant or allergic hand eczema
–Very common
–Difficult to distinguish from dyshidrosis because both are vesicular and very itchy
–Flares occur during work/hobbies, with improvement on vacation when away from the irritant or allergen
- Tinea manus (hand) and tinea pedis (foot)
–Presents as itchy, diffuse, light scale, and/or maceration; prominent on palmar, plantar (moccasin distribution), and interdigital surfaces
–Erythema is rarely present
–Often “two hands and one foot” or “two feet and one hand” are affected
- Scabies
–Presents as short (a few millimeters), linear burrows and vesicles on the hands and feet (web spaces), belt region, and/or intertriginous spaces
–Intensely pruritic, especially at night
–Often many members of the household unit affected
–Definitive diagnosis made by visualizing the scabies mite in a skin scraping
-
Psoriasis
–Often affects the hands and/or feet
–Well-demarcated, erythematous plaques
with adherent scale, or can present as a focal or diffuse pustular eruption
–Look for associated nail dystrophy or other skin involvement
Reiter's disease
–Uveitis, urethritis, and arthritis
-
Pityriasis rubra pilaris
–Well-demarcated bright salmon or red plaques on the palms or soles
-
Keratoderma
–Focal or diffuse thickening of the skin of the palms or soles
Erythema multiforme
Infection (secondary syphilis, varicella meningococcemia)
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hand & Foot Rashes:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
Infectious
-
Enterovirus infection (hand-foot-and-mouth disease, Coxsakie virus, other nonpolio enteroviruses)
-
Kawasaki disease (one of the five criteria)
-
Scabies
-
Tinea
-
Candidal skin infection
-
Ricketsial rash: Rocky Mountain spotted fever (RMSF), murine typhus
-
Mononucleosis (EBV)
-
Measles: Atypical forms start on hands/feet
-
Scarlet fever, post-streptococcal infection desquamation rash
-
Infectious endocarditis: Janeway lesions, Osler nodules
-
Spirochete infection: Secondary syphilis, Lyme disease (acrodermatitis chronica atrophicans)
-
Congenital toxoplasmosis
-
Rat-bite fever (Streptobacillus moniliformis,
Spirillum minus)
Immune-mediated
-
Urticaria: Hands and feet involved in 85% of the cases
-
Juvenile rheumatoid arthritis
-
Systemic lupus erythematosus
-
Raynaud phenomenon (acrocyanosis)
-
Acute graft-vs-host disease
Skin disorders
-
Atopic dermatitis (infantile)
-
Dyshydrotic eczema, pompholyx
-
Chronic allergic contact dermatitis
-
Psoriasis
-
Lichen simplex
-
Papillon-Lefèvre syndrome
-
Olmsted syndrome
-
Acrodermatitis enteropathica (zinc deficiency) can be presenting sign of cystic fibrosis
-
Toxic shock syndrome: Desquamation during the recovery phase; major criteria for staphyloccocal TSS
-
Drugs: Ampicillin, especially in patients with infectious mononucleosis
-
Chronic liver disease: Cirrhosis, hepatoma
-
Metabolic disease: Gangliosidosis
-
Malignancy: Acute leukemia, lymphoma
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Atopic dermatitis:
Causes
(Professional Guide to Diseases (Eighth Edition))
The cause of atopic dermatitis is still unknown. However, several theories attempt to explain its pathogenesis. One theory suggests an underlying metabolically or biochemically induced skin disorder that’s genetically linked to elevated serum immunoglobulin (Ig) E levels. Another theory suggests defective T-cell function.
Exacerbating factors of atopic dermatitis include irritants, infections (commonly caused by Staphylococcus aureus), and some allergens. Although no reliable link exists between atopic dermatitis and exposure to inhalant allergens (such as house dust and animal dander), exposure to food allergens (such as soybeans, fish, or nuts) may coincide with flare-ups of atopic dermatitis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Dermatitis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
The cause of atopic dermatitis is unknown, but a genetic predisposition may be exacerbated by such factors as food allergies, infections, irritating chemicals, temperature and humidity, and emotions. Approximately 10% of childhood cases are due to allergy to certain foods, particularly eggs, peanuts, milk, fish, soy, and wheat. Atopic dermatitis tends to flare up in response to extremes in temperature and humidity. Other causes of flare-ups are sweating and psychological stress.
An important secondary cause of atopic dermatitis is irritation, which seems to change the epidermal structure, allowing immunoglobulin (Ig) E activity to increase. Consequently, chronic skin irritation usually continues even after exposure to the allergen has ended or after the irritation has been systemically controlled.
Atopic dermatitis is most common in infants, usually developing between ages 1 month and 1 year, commonly in those with strong family histories of atopic disease. At least half of those cases clear by age 36 months. These children often acquire other atopic disorders as they grow older. Typically, this form of dermatitis flares and subsides repeatedly before finally resolving during adolescence. However, it can persist into adulthood. In adults, it’s generally chronic or recurring.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Arthritis/Dermatitis:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑Lyme disease
❑Erythema nodosum
❑Rheumatoid arthritis
❑Systemic lupus erythematosus
❑Psoriatic arthritis
❑Disseminated gonococcemia
❑Sarcoidosis
❑Scleroderma
❑Dermatomyositis
❑Reiter syndrome
❑Rheumatic fever
❑Behçet syndrome
❑Still disease
❑Hypersensitivity vasculitis
Clinical Findings
Lyme disease Erythema migrans, a rapidly expanding annular rash with a clearing center, is the key early finding. The site of the ixodid tick bite at the center of the lesion is usually intensely indurated, vesicular, or necrotic. The arthritis is an asymmetric oligoarthritis that usually occurs after the rash has resolved.
Erythema nodosum A prodromal syndrome of fever, chills, malaise, and polyarthralgia is followed by the development of lesions that are discrete, tender, slightly raised subcutaneous nodules on the shins or ankles. They represent a hypersensitivity reaction to group A streptococcal infection, tuberculosis, sarcoidosis, inflammatory bowel disease, or drugs such as oral contraceptives and sulfonamides.
Rheumatoid arthritis Symmetric polyarticular arthritis with synovial proliferation, especially of the wrist, and morning stiffness lasting more than 1 hour characterize the early joint involvement. Rheumatoid nodules appear over extensor surfaces. Vasculitic lesions are frequently found on the digits, appearing as small red or purpuric macules that progress to painful nodules or ulcers.
Systemic lupus erythematosus A classic butterfly rash occurs in 40% and is exacerbated by sun exposure. A diffuse maculopapular rash in areas exposed to the sun heralds disease flares. Discoid lesions and scaling plaques that range in color from red to violaceous, with central atrophy and telangiectasias, occur in 20%. Vasculitis, in the form of painful ulcers on the extremities, palpable purpura, or lupus profundus (firm nodules in the subcutaneous fat on the forehead, cheeks, buttocks, and upper arms) are found. The arthritis is typically one of symmetric fusiform swelling of the proximal interphalangeal and metacarpophalangeal joints, diffuse puffiness of the hands, and tenosynovitis.
Psoriatic arthritis Psoriatic plaques, erythematous with a silvery scale, are critical to diagnosis, but may be hidden in the scalp, umbilicus, or gluteal folds. Nail changes such as pitting or yellow discoloration of the nail plate are other clues. The arthritis typically involves the proximal interphalangeal and distal interphalangeal joints, creating sausage digits. The arthritis may become erosive, leading to telescoping of the hands. One-fourth of patients have axial skeletal arthritis.
Disseminated gonococcemia Acral lesions are typically hemorrhagic pustules, but petechiae, hemorrhagic papules, or hemorrhagic bullae can occur. Fever, rigor, tenosynovitis, and polyarthritis are other findings.
Sarcoidosis Transient maculopapular eruptions of the trunk, face, and extremities are often accompanied by uveitis, adenopathy, and parotid enlargement. Translucent reddish-brown to purple indolent plaques may develop on the face (lupus pernio), buttocks, or extremities. Joint symptoms consist of migratory transient arthralgias.
Scleroderma Early findings are primarily Raynaud phenomenon and puffy fingers. Later findings include sclerodactyly (smooth, shiny, tapered fingers with taut, bound-down skin); contractures with “claw hand” deformity; expressionless face (with thin lips, a beak-like nose, and sunken cheeks); microstomia; mat telangiectasias on the nail folds, face, lips, oral mucosa, or trunk; and calcinosis with leathery crepitation over the joints.
Dermatomyositis The classic skin manifestation is a lilac-colored heliotrope rash on the eyelids and in a butterfly distribution. Gottron papules are violaceous, scaly, flat lesions on the extensor aspect of the interphalangeal joints, elbows, knees, and medial malleoli; these occur as a late manifestation. Proximal muscle aching/weakness, not arthritis, is prominent. The patient is unable to reach overhead or arise from a chair. Neck flexors are more involved than extensors.
Reiter syndrome Arthritis, urethritis, conjunctivitis, and mucocutaneous ulcers are found. The arthritis is asymmetric, usually involving the lower extremity joints. Solitary sausage digits may be seen. Tendinitis and fasciitis are common. The mucocutaneous lesions are eroded red vesicles or papules of the corona and glans, which when confluent are called circinate balanitis. Pustules may change into thick hyperkeratotic plaques on the palms and soles, keratoderma blennorrhagicum.
Rheumatic fever There is an acute migratory polyarthritis with fever. Subcutaneous nodules appear over the bony prominences of the elbows, knuckles, ankles, scapulae, and occiput. They are associated with carditis. Erythema marginatum, appearing as evanescent pink lesions with serpiginous borders, is also associated with carditis.
Behçet syndrome The classic triad is arthritis, iritis, and oral and genital ulcerations. Recurrent aphthous ulcers are a sine qua non. They begin as macular erythema that develops into superficial gray ulcers. Scrotal or labial ulcerations are also found. Hypopyon uveitis, a hallmark, is a rare finding. The arthritis is primarily of the knees and ankles.
Still disease Skin lesions are red, flat, and less than 1 cm in diameter. Lesions are evanescent, occurring with fever spikes. A migratory polyarthralgia occurs.
Hypersensitivity vasculitis After an upper respiratory infection, young adults may develop palpable purpura over the extensor surfaces and buttocks. Arthritis, edema, and colicky abdominal pain, followed by bloody stools, suggests the diagnosis.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Atopicdermatitis:
Causes
(Handbook of Diseases)
Atopic dermatitis is a chronic, inherited skin disorder in which the immune system produces a hypersensitivity reaction to environmental allergens that are often difficult to identify.
Exacerbating factors of atopic dermatitis include irritants, infections (commonly caused by Staphylococcus aureus), and some allergens. Although no reliable link exists between atopic dermatitis and exposure to inhalant allergens (such as house dust and animal dander), exposure to food allergens (such as soybeans, fish, or nuts) may coincide with flare-ups of atopic dermatitis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Dermatitis:
Causes
(Handbook of Diseases)
The cause of atopic dermatitis is unknown, but there is a genetic predisposition exacerbated by such factors as food allergies, infections, irritating chemicals, temperature and humidity, and emotions. Approximately 10% of childhood cases are caused by allergy to certain foods, particularly eggs, peanuts, milk, and wheat.
Atopic dermatitis tends to flare up in response to extremes in temperature and humidity. Other causes of flare-ups are sweating and psychological stress.
An important secondary cause of atopic dermatitis is irritation, which seems to change the epidermal structure, allowing immunoglobulin (Ig) E activity to increase. Consequently, chronic skin irritation usually continues even after exposure to the allergen has ended or after the irritation has been systemically controlled.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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