Diagnosis and treatment of hand dermatitis

Investigating Hand Dermatitis and Related Dermatologic Quality of Life Among Nursing Students During the COVID-19 Pandemic

OBJECTIVE

To investigate hand dermatitis and related dermatologic quality of life among nursing students during the COVID-19 pandemic period.

METHODS

In total, 241 nursing students participated in this cross-sectional descriptive study. The data were collected using a sociodemographic data collection form, Hand Dermatitis Self-assessment form, and the Dermatological Quality-of-Life Scale.

RESULTS

During their clinical practice during the COVID-19 pandemic period, 41.9% of participants experienced hand dermatitis. Participants with a history of allergies experienced hand dermatitis at higher rates than those with no history of allergies ( P < .01). The most frequently reported symptom associated with hand dermatitis was "irritation and itching in the hands" (53.9%). Dermatological Quality-of-Life Scale scores differed significantly among participants who did and did not have hand dermatitis: those who experienced hand dermatitis or symptoms of hand dermatitis reported lower quality of life ( P < .01 and P < .05, respectively). Participants' most frequently reported cause of hand dermatitis was the use of antiseptic agents (44.8%), and their most frequently reported preventive measure was the use of moisturizers (61.8%).

CONCLUSIONS

Nursing students in the COVID-19 pandemic period experienced a high rate of hand dermatitis. Both the presence and symptoms of hand dermatitis were associated with lower dermatologic quality-of-life levels for the nursing students.

Hand Dermatitis among Nurses during the COVID-19 Pandemic: Frequency and Factors

OBJECTIVE

To determine the frequency of hand dermatitis among nurses during the COVID-19 pandemic and factors affecting its prevalence.

METHODS

The research sample consisted of 175 nurses working in state hospitals. Research data were collected via Google survey between September and October 2020. The data were collected using a sociodemographic data collection form, and a self-assessment form was used to determine dermatologic symptoms.

RESULTS

The frequency of hand dermatitis among nurses was 70.9%. A statistically significant difference was found between sex, allergy history, and increased frequency of handwashing and the frequency of hand dermatitis. No significant difference in terms of the frequency of hand dermatitis was found between nurses who provided care to patients who were COVID-19 positive versus nurses who provided care to patients who were COVID-19 negative. However, the frequency of washing hands and using hand disinfectants and hand creams was found to have increased significantly during the COVID-19 pandemic compared to the prepandemic period.

CONCLUSIONS

The frequency of hand dermatitis increased among nurses during the pandemic. The increased frequency of handwashing during the pandemic poses a risk for hand dermatitis among nurses, although this should not discourage nurses from appropriate hygiene.

Hand Dermatitis in Nursing Students

OBJECTIVE

To determine the frequency of self-reported hand dermatitis and the factors influencing its prevalence among nursing students.

METHODS

Researchers collected demographic data and used a self-assessment form to identify dermatologic symptoms. The questionnaires were distributed to the students and collected again after the students completed the forms.

RESULTS

Hand dermatitis was present in 20.9% of nursing students. The most common symptoms were irritation/pruritus, redness/cracking, flaking/rash, swelling, and vesicles in hands. The grade of the student, the presence of allergy complaints, and medication used to treat dermatitis were statistically significantly associated with dermatitis prevalence. The use of gloves and cleansing agents used in handwashing were factors linked to hand dermatitis.

CONCLUSIONS

Hand dermatitis increases in parallel with the increase of clinical practice hours among nursing students. Familial and environmental factors also increase the risk of hand dermatitis.

The color of skin: red diseases of the skin, nails, and mucosa

Red color is pervasive in local and systemic skin conditions. It is a color that often reflects variations of dermal blood flow and extends beyond the rubor and calor of inflammation. The pathophysiology of red skin involves remote and local chemical mediators that dilate arteriolar smooth muscle and increase blood flow to superficial vessels and capillary beds. Incident light hits hemoglobin, which preferentially absorbs light of shorter wavelengths, such as blue, and reflects warmer colors. Due to its pervasiveness and consistency, red color is a useful descriptive factor in helping narrow a differential diagnosis. Red skin disorders include a variety of conditions involving endocrine mediators, cardiovascular responses, and the disruption of the skin barrier. An understanding of the blood's role in these disorders equips clinicians to generate differential diagnoses through the lens of pathophysiology. Dermatologists can improve management by considering red skin as part of systemic disease rather than as an isolated incident.

IL-24 contributes to skin inflammation in Para-Phenylenediamine-induced contact hypersensitivity

Para-Phenylenediamine (PPD) is an aromatic amine used in hair dyes and in temporary black henna tattoos, which is a frequent cause of allergic contact dermatitis (ACD). ACD is a skin inflammatory reaction characterized by modifications such as spongiosis, exocytosis and acanthosis. The aim of this study is to characterize the expression and the role of IL-20-related cytokines, including IL-19, IL-20, IL-22 and IL-24, in ACD. The expression of IL19, IL20, IL22 and IL24 is increased in affected skin from PPD allergic patients compared with uninvolved skin. In addition, the expression of these cytokines positively correlates with clinical symptoms. To assess their role in ACD, we set up a mouse model of PPD-induced allergic contact dermatitis and we showed that, in contrast to Il22-deficient mice, Il22ra1-, Il20rb- and Il24-deficient mice are partially protected against development of PPD-induced contact hypersensitivity. These mice have decreased ear thickening and less acanthosis compared with WT mice after PPD treatment. In addition, the absence of IL-22R, IL-20R2 or IL-24 affects the recruitment of neutrophils into the skin but not the total IgE production. Taken together, these results demonstrate the implication of IL-24 via the IL-20R type II receptor in the inflammatory process of ACD.

Vesicular hand dermatitis

Vesicular hand dermatitis is a type of eczema involving the fingers, hands, and sometimes the feet. It is common in primary care, requiring prompt treatment to prevent chronicity. The cause is often unknown, making the condition challenging to treat. Management consists of avoiding irritants and using emollients and topical corticosteroids.

A Severe Case of Recalcitrant Pompholyx

BACKGROUND

Pompholyx is an inflammatory vesiculobullous skin disease of the hands and feet belonging to the spectrum of eczema.

OBJECTIVE

To report a severe case of pompholyx, its clinical presentation, and its management.

METHODS

A medical chart review was conducted on a patient with this condition.

RESULTS

The patient was patch tested according to the North American Contact Dermatitis Group (NACDG) Standard Screening Series, and results were negative. In the past, she was treated with corticosteroid creams as well as narrow band ultraviolet B (UVB), and Psoralen ultraviolet A (PUVA) therapies, and none were beneficial. When the frequency of the episodes increased, methotrexate was introduced but failed to control the condition. Next, mycophenolate mofetil was started and gradually increased to 3.5 g daily along with a separate trial of radiotherapy with marked success.

CONCLUSION

Pompholyx can be challenging to manage, and treatment can involve an assortment of therapies over a prolonged period of time.

Hand dermatitis: an allergist's nightmare

Hand dermatitis is a common skin complaint. We use our hands to explore our environment; subsequently, our hands are in frequent contact with potential allergens and irritants. Patients with hand dermatitis may present to their allergist with this complaint. Approaching the diagnosis and treatment of hand dermatitis can be challenging, as both internal and external factors may contribute to the overall condition. Furthermore, the differential diagnosis of hand dermatitis is broad and the cause often multifactorial. Obtaining a thorough history and performing a focused examination may help the clinician differentiate between multiple causes of hand dermatitis. Numerous treatment options exist for hand dermatitis, and new potential treatments are in development as well. We aim to provide the allergist with a streamlined toolkit for help in the diagnosis and management of hand dermatitis.