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Clinical evaluation of atopic hand-foot dermatitis.

Clinical manifestations of atopic hand-foot (H-F) dermatitis have not been well studied. This study examined 108 atopic dermatitis (AD) patients with H-F dermatitis between May 1997 and July 1999 at our AD clinic to determine the clinical characteristics of atopic H-F dermatitis and to assess its etiologic associations. It usually began in childhood with an early onset of AD. Pruritus was the most frequent symptom, and erythema, scales, lichenification, hyperkeratosis, fissures, and keratolysis exfoliativa were also common signs. Both the hands and feet were involved in 47 (44.0%) patients, and either hand or foot involvement was observed in 15 (13.9%) and 46 (42.6%) patients, respectively. Palmar or plantar surfaces were more frequently involved than the dorsal aspects. The great toe was affected more often than the other toes. Two-thirds of patients presented with manifestations of the ichthyosis triad and sandpaper-like skin lesions on the elbow, knee, and lateral malleolus. Palmar or plantar hyperhidrosis was reported in 15% and 20%, respectively. The ichthyosis triad-associated group showed a significantly higher incidence of sandpaper-like (thickened, roughened) skin lesions, and these patients had lesions on the dorsal hands or heels and lateral malleolus more frequently than ichthyosis triad-absent patients. The hyperhidrosis-associated group showed an association with glassy lesions, localized to palmar or plantar areas. Atopic H-F dermatitis is associated with the nonallergic etiologies of AD and clinical subgroups can be identified on the basis of nonallergic backgrounds.

Child↗
PubMed1996

Recurrent focal palmar peeling.

Recurrent focal palmar peeling, previously known as keratolysis exfoliativa, is an idiopathic condition characterized by chronic palmar and occasionally plantar peeling. It can be exacerbated by environmental factors, and may be misdiagnosed as chronic contact dermatitis. Accurate diagnosis is from the history and examination. It is supported by a negative patch test result. Three cases of recurrent focal palmar peeling are presented, of which two were misdiagnosed as chronic dermatitis. Although there are few references on recurrent focal palmar peeling, it is likely to be a common condition that rarely presents to dermatologists because it is largely asymptomatic. A correct diagnosis is essential due to the social, occupational and legal implications if misdiagnosed.

Adult↗
PubMed1985

[Clinical course of childhood atopic neurodermatitis. A catamnestic study of 121 cases].

121 patients who had been treated because of atopic dermatitis (AD) in 1967-1970 (at the age of 1-10 years) at the Department of Dermatology, University Hospital of Zurich (in- and outpatient department), were controlled by means of questionnaires, 62 of them were also personally examined. Interesting items were localisation of the AD, influences on its course, as well as micromanifestations. Infantile atopic eczema was most often localized on the face (65.3%) and on the hair-covered head (34%). The elbows and popliteal regions were attacked in 27% each. In 63% of the patients, personal examination revealed typical lesions of AD, mostly occurring on the elbows (59%) and popliteal areas (56.4%). Other common localisations were: wrist (34%), neck (31%), ankles (31%), eyelids (21%), as well as the areas behind the ears (13%). 73% of the patients had dry skin, only 8% showed a fatty one. In 66.7%, we observed the eczematic form of reaction, in 66.7% the lichenoid type, and in 10.3% the pruriginous form. 26% of the patients actually suffering from AD had perlèche or cheilitis exfoliativa, 54% of them showed follicular keratosis. 17% of the examined persons, who actually did not suffer from classic AD, had perlèche, 56% of them follicular keratosis. We discuss the possible interrelation between these findings and ichthyosis vulgaris which often occurs concomitantly. The course of AD is influenced by seasons in 77%. Deterioration of the skin conditions was predominantly found in periods of psychical stress (22%), with nervousness (33%), or with sweating (51%).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗