Abramovits William, Stevenson Lisa C
Division of Dermatology and Medicine, Baylor University Medical Center, Dallas, TX, USA.
Skinmed. 2005 Jul-Aug;4(4):204-10.
Many of the eczema cases seen by dermatologists involve the hands. The discomfort and embarrassment of hand dermatitis in any of its forms may compromise a patient's quality of life, causing frustrated attempts to identify the cause of the disease and engendering disappointment with treatment failures.
The authors assessed the severity scores for each patient, personal and familial histories of atopy, coexisting conditions, triggers of irritation, types of treatments, and their success rates. The authors administered a comprehensive survey to 50 consecutive patients presenting with eczematous dermatitis on the ventral aspect of the hands. The authors used a novel hand eczema severity index and a questionnaire that assessed personal and familial histories of atopy as well as coexisting conditions, triggers, and sources of irritation; types of treatments employed; and success rates. Patients were also encouraged to complete a composite quality of life assessment.
Results reveal a high frequency of personal and familial atopy, a 58% prevalence of contact allergy, a 67.4% history of hay fever, 25.6% cases of asthma, and a 44% incidence of fungal infection, which was one of the most common coexisting conditions.
Both topical immunomodulators and topical corticosteroid therapy treatments demonstrated an impressive efficacy. An overlap should be considered when clinical symptoms and histological results vacillate between psoriasis and eczema.
皮肤科医生诊治的许多湿疹病例都涉及手部。手部皮炎无论何种形式所带来的不适与尴尬，都可能损害患者的生活质量，导致患者在试图找出病因时受挫，并因治疗失败而感到失望。
作者评估了每位患者的严重程度评分、特应性的个人及家族病史、共存疾病、刺激诱因、治疗类型及其成功率。作者对连续50例手部腹侧出现湿疹性皮炎的患者进行了全面调查。作者使用了一种新型手部湿疹严重程度指数和一份问卷，该问卷评估了特应性的个人及家族病史以及共存疾病、诱因和刺激源；所采用的治疗类型；以及成功率。还鼓励患者完成一份综合生活质量评估。
结果显示个人及家族特应性的发生率很高，接触性过敏患病率为58%，花粉症病史为67.4%，哮喘病例为25.6%，真菌感染发生率为44%，真菌感染是最常见的共存疾病之一。
局部免疫调节剂和局部皮质类固醇疗法均显示出令人印象深刻的疗效。当临床症状和组织学结果在银屑病和湿疹之间摇摆不定时，应考虑两者存在重叠。
