Onder Meltem, Oztas Murat, Arnavut Onder
Gazi University School of Medicine, Department of Dermatology, Ankara, Turkey.
Int J Dermatol. 2002 Nov;41(11):771-2. doi: 10.1046/j.1365-4362.2002.01533.x.
A 65-year-old retired man with hand eczema presented to the Dermatology clinic in October of 2001. He complained of scaly, fissured plaque-type lesions over the radial margin of his right index finger and thumb (Fig. 1). He first noticed these changes 2 years ago. There was no history of irritation from his occupation. None of the other family members were affected. There was no history of atopy or psoriasis. The physical examination was remarkable for scaly, fissured, hyperkeratotic patches on the palms and palmar surfaces of the finger tips of the right hand. No nail changes were noted. The other fingers were free from lesions. There were no changes on the feet or soles. A diagnosis of eczema was suspected. Hobbies and repeated trauma to the hands were investigated. He had a habit of "nargile" smoking,starting at 35 years of age and he was using this apparatus more than 2 h a day. We performed patch tests with European standart test serial and they were negative. Yeast examination using KOH was negative. The diagnosis of Nargile (Hubble-bubble) eczema was made. It was advised that he stop smoking. Mild topical corticosteroids and emollient with urea were started. Clinical evaluation demonstrated resolution of the lesions after 2 weeks of therapy.
一位65岁的退休男性患有手部湿疹，于2001年10月前往皮肤科诊所就诊。他主诉右手食指和拇指桡侧边缘有鳞屑、裂隙性斑块样损害（图1）。他2年前首次注意到这些变化。他的职业没有刺激性病史。其他家庭成员均未患病。无特应性或银屑病病史。体格检查发现右手掌和指尖掌面有鳞屑、裂隙、角化过度斑。未发现指甲改变。其他手指无损害。足部和脚底无变化。怀疑为湿疹。对其爱好和手部反复外伤情况进行了调查。他有“水烟袋”吸烟的习惯，35岁开始，每天使用该烟具超过2小时。我们用欧洲标准试验系列进行了斑贴试验，结果均为阴性。用氢氧化钾进行的酵母菌检查结果为阴性。诊断为水烟袋湿疹。建议他戒烟。开始使用温和的外用皮质类固醇和含尿素的润肤剂。临床评估显示治疗2周后损害消退。
