In article <3765E48C.B20BB2DB at home.com>, Scott <scott at home.com> wrote:
>I have had for nearly 3 years a moderate to severe dermatitis on both
>hands. Only the palmar surface of the fingers are affected, with
>occasional spreading to the palms. Tiny blisters form that rupture
>through the skin and create tiny open sores that heel slowly. At times
>my hands have become lichonified with thick, irritable skin. The onset
>of this dermatitis did not accompany any changes in my life or home. No
>detergents, soaps, clothing, furniture, etc. were changed either.
> I have been worked up by an immunologist who told me that he did not
>know what the cause was treated me empirically with a steroid cream. I
>was tested for every allergen that he ( the immunologist) suspected.
>Now, I am a medical student and the obvious suspect is latex. However,
>I have tested negative for a latex RAST, and the symptoms seem to be
>independent of glove type, size, latex v. non latex, powdered v non
>powdered, etc... It does not seem to matter if have been wearing gloves
>alot or not.
>>QUESTION #1 Does anyone have any ideas as to what may be causing
>this? Or has anyone seen someone with some kind of hypersensitivity
>that is limited to only a portion of the hands?
>>Question#2 What are the possible side effects of long-term
>corticosteroid cream (fluocinonide 0.1%) application to the hands, as it
>seems I may be forced to use this for years to come?
>>Thank you for your help
>Scott
Scott, this sounds very much like dyshidrosis, and the people to consult
about it are he dermatologists rather than the allergists. It would be
extremely rare to see a contact hypersensitivity reaction affecting the
palms of the hands and not the dorsa as well. The skin of the palm is so
tough, compared to that of the back of the hand, that is is almost never
affected alone. There are special cases, such as that of a butcher who used
a knife with a cocabola wood handle, but such cases are pretty obvious.
Latex is certainly not the obvious offender here.
--
Larry Preuss
Ann Arbor, MI
USA
