Hand Eczema

　　Irritating causes

　　The common causes of hand eczema include various irritants, but there are significant differences in susceptibility among individuals. Excessive humidity in the surrounding environment is the most important aspect among all causes. Acute attacks are mainly manifested as skin erythema and inflammation, edema, or exudation caused by cracking, while chronic attacks are mainly manifested as skin erythema, edema, and symptoms such as the appearance of scales and cracks, with a duration exceeding 40 days.

　　Allergic causes

　　An important cause of hand eczema is allergen hypersensitivity. Acute onset is mainly characterized by skin erythema, edema, vesicles, and scabs. Chronic onset is mainly characterized by skin hyperpigmentation, lichenification, and fissures, with more mild episodes presenting as skin itching.

　　Endogenous causes

　　Atopic constitution is an important internal factor in the development of hand eczema. For individuals with allergic constitutions, they are abnormally sensitive to external stimuli and can trigger allergic reactions even with minimal exposure to allergens. Research data show that atopic constitution is more likely to induce eczema on the dorsal and palmar sides of the wrist.

　　One: Affecting life:

　　If chronic eczema is not treated promptly, it can last for several months or even years, with increased itching in the morning or before bedtime, affecting normal life and psychological state. Patients often lose confidence in treatment due to the lack of effective treatment.

　　Two: Endangering life and health:

　　Chronic eczema often leads to erosion due to scratching, which can lead to secondary infection and the formation of abscesses with local lymphadenopathy. The local skin thickens, becomes rough, and presents with lichenoid changes, which are difficult to heal. Some eczema patients may develop systemic diseases due to prolonged illness and excessive medication, especially affecting the liver and kidneys, with severe cases being life-threatening.

　　Three: Inducing other diseases:

　　Chronic eczema can induce other diseases, such as less common infections like herpes simplex virus, warts, or infectious plaques. Some children may also worsen their eczema symptoms if they are allergic to certain foods or environmental substances.

　　The subjective symptoms are mainly itching, but they can also include tingling or burning sensations, or an insect crawling feeling. The objective symptoms can be classified into several types according to the mechanism:

　　Skin irritation Primarily caused by acute or chronic irritation, leading to irritant dermatitis. Chronic cases are more common in middle-aged and young women, especially housewives, hence also known as housewife's dermatitis. The characteristics include dry erythema, fissures, and desquamation, with rare edema and bullae.

　　Allergic contact dermatitis The onset can be acute or chronic. Acute cases often have a clear history of exposure. Lesions are usually seen on the dorsal skin of the hand. For example, allergic to latex, contact dermatitis may occur from wearing latex gloves, with prominent itching, erythema, papules, vesicles, and exudation. Chronic patients often have an unclear history of exposure and may require patch testing to determine the cause. For example, there are reports of chronic hand erythema and hypertrophy due to nickel allergy in occupational tools.

　　Keratotic hypertrophic eczema It can occur on the palm or dorsal side of the hand, presenting as localized plaques of hypertrophic keratosis, which may be accompanied by fissures or mild desquamation. There is usually no exudation, and the cause is often not found at present.

　　Keratotic eczema Common in males, characterized by keratotic hyperplastic patches on the palm or fingers, which are dry, clearly demarcated, and inflammatory. The condition is usually worse in winter and better in summer, often worsening due to excessive washing and exposure to soap or detergents.

　　Dyshidrotic eczema Deep bullae may appear on the palm, fingers, or lateral edge, accompanied by itching, which may lead to scales sometimes in a collar-like pattern. The inflammation is usually not prominent, but it can also cause erosion and exudation. Purulent vesicles may appear in cases of infection, and some may present with dry scaly lesions, accompanied by fissures without bullae.

　　Discoid eczema Mostly seen on the back of the hand, presenting as few coin-sized scaly or erythema exudative damage, tending to become moist. Symmetrical, with subjective itching.

　　Reduce contact with irritants

　　To avoid the hands getting wet and dry, and dry and wet again, which may worsen the injury, it is best to do household chores together and use more automatic appliances such as washing machines and dishwashers. It is necessary to wash hands less often and use less soap. It is best to use non-soap-based cleaning agents instead of soap. Because both too hot and too cold water are harmful to the skin, it is best to use warm water. When washing hands, be sure to rinse thoroughly, especially the dirt and detergents hidden in the crevices of the fingers. Paying attention to hand hygiene is also a key to preventing hand eczema.

　　Use gloves

　　The best way to reduce the chance of the hands being stimulated is to: develop the habit of wearing gloves when doing things. When doing household chores involving water, wear two layers of gloves, with the inner layer being a sweat-absorbing cotton glove and the outer layer being a waterproof plastic glove. It is best to have several pairs of gloves ready, and change the cotton gloves when they are wet with sweat, and change the plastic gloves immediately when they are torn. It is not advisable to wear only plastic gloves, because the hands that are wet with sweat and dirt are more susceptible to allergens and irritants, leading to the worsening of eczema. Even if wearing two pairs of gloves, it is necessary to temporarily remove the gloves for half an hour to an hour to let the hands breathe. When doing non-water-related household chores, it is best to wear cotton gloves to prevent the hands from getting dirty and absorbing the skin. Neglecting this situation may also lead to the occurrence of hand eczema.

　　Reduce friction

　　When the skin is dry, friction is easy to break the skin and worsen the changes of eczema, so it is necessary to avoid twisting dry clothes, towels, and other actions. Touching newspapers and chalk will wash off the oil and moisture of the skin, and dry paper will cut the skin, which will worsen the eczema. It is best to avoid this or wear cotton gloves. When cleaning, do not wear rings, and wearing rings while doing housework may cause irritants or detergents to accumulate locally, increasing skin friction and irritation, and may also cause nickel allergy. After washing hands, apply hand cream immediately, and also apply it whenever the hands feel dry. In addition, it is necessary to reduce the behavior of peeling off skin scales. Applying hand cream regularly is also a key to preventing hand eczema.

　　Strengthen hand care

　　The protective layer on the surface of the skin of the hand with eczema has been eroded and eroded, and it needs to be protected as much as possible. Many people ignore this point, and continue to expose their hands to chemicals, detergents, metal plastic products, and other erosion and destruction during treatment, which of course makes it easier to relapse or difficult to cure.

　　Actively treat other diseases

　　Some people have other diseases, the blood supply and nutrition of the hands are affected, the local skin structure itself is affected, or there is a local fungal infection, which may affect the treatment effect of hand eczema. It is necessary to treat other diseases in a timely manner in order to better treat hand eczema.

　　Hand eczema, at the time of diagnosis, in addition to relying on its clinical manifestations, also needs the assistance of auxiliary examinations. The examination items required for this disease include: skin smear microscopic examination, skin fungus microscopic examination, urine routine test, blood routine test, and physical examination of dermatological diseases.

　　1. Bitter Melon Bitter melon contains quinine. It has the effects of clearing heat and detoxifying, removing dampness and itching. It can be used to treat heat toxins, boils, boils, eczema, and other diseases.

　　2. Tomato Tomatoes are rich in vitamin A, vitamin B1, vitamin B2, vitamin C, niacin, vitamin E; they also contain malic acid, citric acid, calcium, phosphorus, iron, and tomatine, etc. Tomatoes have the effects of promoting saliva, relieving cough, improving digestion, cooling blood, calming the liver, and clearing heat. The fruit acids in tomatoes have a protective effect on vitamin C, so they can effectively supplement vitamin C; tomatine has the effects of antibacterial and anti-inflammatory, reducing vascular permeability, so the external application of tomato juice can have an anti-itching and astringent effect in treating eczema.

　　3. Spinach Spinach contains beta-carotene, vitamin B1, vitamin C, calcium, phosphorus, iron, protein, fiber, etc. Spinach also has the effect of detoxifying and removing dampness, so spinach juice can be applied externally to treat eczema.

　　4. Choose foods with cooling and diuretic properties for the diet.Such as mung beans, adzuki beans, amaranth, spinach, purslane, winter melon, cucumber, lettuce, etc.

　　5. Eat more foods rich in vitamins and minerals.Such as Shao ye vegetables, carrots, fresh fruits, tomatoes, etc., to regulate the physiological functions of the human body, alleviate skin allergic reactions.

　　6. To maintain normal digestion and absorption, food should be light in taste, with less salt and sugar to avoid excessive accumulation of water and sodium in the body, which may加重 the exudation and pain and itching of the rash, leading to skin erosion.

　　7. After illness, avoid chili, bamboo shoots, shrimp, crabs, glutinous rice, eggplant, scallions, garlic, pepper, mushrooms, chives, broad beans, curry, coffee, cigarettes, alcohol, cocoa, seafood, etc. Eat less meat.

　　Find the cause and remove it as much as possible to avoid water washing or contact with various detergents and cleaning agents. Antihistamines can be taken internally for itching; for those with hyperkeratosis, oral vitamin A acid (Vitamin A Capsules), etretinate (Avita), but attention should be paid to side effects. For refractory cases, intravenous drugs such as tripterygium glycosides and cyclosporin can be taken. Local external drugs can be treated according to eczema.