Typical clinical signs of hand eczema are redness, infiltration of the skin, scaling, edema, vesicles, areas of hyperkeratosis, cracks (fissures), and erosions . It is a prevalence of 4% among adults in the general population . The work-related cases are ususally more severe than cases in the general population, the incidence of occupational associcated is between 0.7 and 1.5 cases per 1000 workers per year, with much higher incidences among certain occupations, such as hairdressing .
The most common external cause of hand eczema is contact with mild toxic agents or irritants (e.g., detergent, water and soaps), causing irritant contact dermatitis. Allergic contact dermatitis is less common than irritant contact dermatitis and reflects a contact allergy to a specific substance, such as rubber, nickel, or perfumes . Atopic dermatitis is an endogenous cause of hand eczema; one third to one half of patients with hand eczema may have atopy, and atopy may be manifested exclusively as dermatitis of the hands.
A 51-year-old hair stylist presents with redness of the hands and reports the intermittent occurrence of tiny vesicles, scaling, and fissuring, accompanied by itching on the palms, fingers, and dorsal sides of the hands. Her hair solon work requires frequent hand washing and continued exposure to hair shampoo and dye. Frequent application of Tangs herbal cream is an essential part of management, in combination with Tangs Herbal Medicine. The lesions healed completely after 9 months (Panel Month 9). We recommend the use of impermeable gloves with a cotton lining when performing “wet” tasks in her hair salon.
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