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Acute Hand Eczema

JOE R. MONROE, PA, MPAS

Dawkins Dermatology, Oklahoma City, Oklahoma

 

eczema

A 16-year-old boy presented with an acute case of hand dermatitis (A), which had been made worse by self-treatment with numerous agents, including hydrogen peroxide, alcohol, bleach, topical antibacerial creams, and multiple lotions. The boy had always had a mild case of chronic hand eczema, but it had become more severe after he started a new job that required him to wash several cars a day.

eczema

Treatment consisted of the following: withholding all topical medications except those prescribed, oral antibiotic for a presumed secondary bacterial infection (cephalexin 500 mg qid for 7 days), 40 mg of prednisone tapered over 2 weeks, and topical clobetasol ointment under occlusion at bedtime. The second photograph (B) shows the improvement after 1 week of treatment.