Hand dermatitis. The perennial scourge.

Hand eczema continues to bedevil both patients and physicians. While appropriate and judicious intervention minimizes aggravation, discomfort, and inconvenience, recurrences are frequent. Treatment with corticosteroids is often effective for irritant dermatitis. Efforts to avoid the irritant, protect the hands, and use emollients are vital in preventing recurrence. Protection and avoidance are also the key techniques to teach patients with allergic dermatitis. In the case of pompholyx, experts now believe the condition is caused by stress or emotional turmoil, so the most helpful intervention may be patient education about stress management. Recognizing the role of irritants encountered at work, at home, and in the recreational setting offers physicians the opportunity to intervene preemptively. When patients avoid unnecessary exposure and protect the skin against climatic instability, the toll exacted by hand eczema can be dramatically reduced.