Hand dermatitis | DermNet NZ

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Updated by Dr Karen Koch, Consultant Dermatologist, Donald Gordon Medical Clinic, University of the Witwatersrand, Johannesburg, South Africa. March 2018.

What is hand dermatitis?

Hand dermatitis is a common acute or chronic eczematous disorder that affects the dorsal and palmar aspects of the hands due to a variety of causes.

Hand dermatitis is also known as hand eczema.

Hand dermatitis

See more images of hand dermatitis.

Who gets hand dermatitis?

Hand dermatitis is common, especially in young adult females, and accounts for 20–35% of all forms of dermatitis. It may occur at any age, including during childhood. It is particularly prevalent in people with a history of atopic dermatitis. [see also Atopic hand dermatitis]

Chronic hand dermatitis is estimated to affect 10–15% of the population [1].

Hand dermatitis is particularly common in industries involving wet work or exposure to chemicals such as cleaning, catering, metalwork, hairdressing, healthcare, housework, painting and mechanical work. This is mainly due to contact with irritants, but specific contact allergies can contribute [2].

What causes hand dermatitis?

Hand dermatitis often results from a combination of causes, including:

Hand dermatitis is frequently caused or aggravated by work when it is known as occupational dermatitis.

Irritants include water, detergents, solvents, acids, alkalis, cold, heat and friction. These can damage the outer stratum corneum, removing lipids and disturbing the skin’s barrier function. Water loss and inflammation lead to further impairment of barrier function.

In atopic dermatitis, a deficiency in or defective function of the filaggrin protein in the stratum corneum leads to barrier dysfunction resulting in water loss and easy penetration by irritants and allergens [3].

Contact allergy is a delayed hypersensitivity reaction with elicitation and memory phases involving T lymphocytes and release of cytokines [2].

What are the clinical features of hand dermatitis?

Hand dermatitis may affect the backs of the hands, the palms, or both. It can be very itchy, often with a burning sensation, and is sometimes painful. It has acute, relapsing, and chronic phases.

Acute hand dermatitis presents with:

• Red macules, papules, and plaques
• Swelling
• Blistering, weeping, crusting
• Fissuring.

Features of chronic hand dermatitis include:

• Dryness and scale
• Lichenification.

There are various causes and clinical presentations of hand dermatitis.

Hand dermatitis

Atopic hand dermatitis

Atopic hand dermatitis is due to impaired skin barrier function and is triggered by contact with irritants. It usually involves the backs of the hands and around the wrists. It may manifest as a discoid or vesicular pattern of eczema. Patients will typically have signs of atopic dermatitis elsewhere such as in the flexures.

Discoid eczema

Discoid eczema (nummular dermatitis) tends to affect the dorsal surfaces of the hands and fingers as circumscribed plaques. Other sites of the body may or may not be affected.

Vesicular hand dermatitis

Vesicular hand dermatitis is also known as pompholyx. Intensely itchy crops of skin-coloured blisters arise on the palms and the sides of the hands and fingers. Similar symptoms often affect the feet. It is likely this form of dermatitis is triggered by sweating (hyperhidrosis) such as in hot and/or humid weather and with emotional stress.

Chronic relapsing vesiculosquamous dermatitis

Chronic relapsing vesiculosquamous dermatitis is a common pattern of palmar and finger dermatitis, in which episodes of acute vesicular dermatitis are followed by chronic scaling and fissuring.

Hyperkeratotic hand dermatitis

Hyperkeratotic hand dermatitis is a chronic, dry, non-inflammatory palmar dermatitis. It can appear similar to palmar psoriasis but is less red and less well circumscribed.

Fingertip dermatitis

Fingertip dermatitis can be isolated to one or several fingers.

Irritant contact dermatitis

The hands are the most common site for irritant contact dermatitis and are often due to wet work and repeated exposure to low-grade irritants. The finger-webs are the first place to be affected, but inflammation can extend to fingers, the backs of the hands and the wrists. Irritant contact dermatitis often spares the palms.

• Acute irritant contact dermatitis is due to injury by potent irritants such as acids and alkalis, often in an occupational setting.
• Repeated exposure to low-grade irritants such as water, soaps, and detergents leads to chronic cumulative irritant dermatitis.

Allergic contact dermatitis

Allergic contact dermatitis may be difficult to distinguish from constitutional forms of hand dermatitis and irritant contact dermatitis. There are about 30 common allergens and innumerable uncommon or rare ones that may affect the hands. Common allergens include nickel, fragrances, rubber accelerators (in gloves) and p-phenylenediamine (permanent hair-dye). Clues to contact allergy depend on the allergen, but may include:

• Periodic flare-ups associated with certain tasks or places hours to days earlier
• Irregular, asymmetrical distribution of the rash
• Sharp border to the rash (eg, at the wrist, corresponding with the cuff of rubber glove).

What are the complications of hand dermatitis?

• Bacterial skin infections (staphylococci and/or streptococci) can result in pustules, crusting and pain.
• Dermatitis at the ends of the fingers may result in deformed nails.
• Dermatitis can spread to affect other sites, particularly the forearms and feet.

How is hand dermatitis diagnosed?

Hand dermatitis is usually straightforward to diagnose and classify by history and examination, considering:

• Acute, relapsing, or chronic course
• Past history of skin disease
• Dermatitis on other sites
• Occupation and hobbies.

However determining the cause of a hand dermatitis can be complicated as it may be multifactorial.

Patients with chronic hand dermatitis may require patch tests to detect contact allergens. 

A punch biopsy and skin scrapings (mycology) may be necessary to exclude other causes of inflammation of the hands.

What is the differential diagnosis for hand dermatitis?

• Contact urticaria — for example, to latex gloves (immediate redness, itching and swelling that resolves within an hour)
• Protein contact dermatitis, most often affecting caterers (a combination of urticaria and dermatitis induced by reactions to meat)
• Psoriasis (symmetrical, well-circumscribed, red, scaly plaques)
• Tinea manuum (unilateral or asymmetrical, peripheral scale). 

Patch testing patients with hand dermatitis

What is the treatment for hand dermatitis?

Patients with all forms of hand dermatitis should be most particular to:

• Minimise contact with irritants — even water
• Use non-soap cleanser when washing hands, rinse carefully, and ensure hands are completely dry afterwards
• Note that cream cleansers are not antimicrobial; soap and water or a sanitiser is needed for washing hands in order to destroy pathogens such as the SARS-CoV-2 virus responsible for COVID-19
• Completely avoid allergens that have been identified by patch testing
• Wear task-appropriate protective gloves
• Apply thick emollients before work/school and reapply after washing or when the skin dries out (this can be 10–20 times in a day).

Vinyl gloves are less likely than rubber gloves to cause allergic reactions.

• They must be scrupulously clean and should have no holes.
• They should not be worn for long periods.
• Sweating under the gloves aggravates dermatitis.
• Lined gloves or inner cotton gloves improve comfort.

Topical steroids reduce inflammation.

• Use a potent topical steroid on dermatitis on the backs of the hands and an ultrapotent topical steroid on palms.
• Cream formulation is usually best for vesicular hand dermatitis, and an ointment base for chronic dermatitis.
• They should be applied to areas of active dermatitis once or twice daily for several weeks, then discontinued or frequency/potency reduced.
• Short-term occlusion increases potency and is warranted if standard applications have not been effective.

Calcineurin inhibitors (tacrolimus and pimecrolimus) have some evidence to show efficacy in hand eczema and can be used as a steroid-sparing agent [4].

Alitretinoin has been approved for treatment of hand dermatitis in some countries.

Secondary bacterial infection may require an oral antibiotic, usually flucloxacillin.

Severe acute flares of hand dermatitis are treated with short course oral prednisone (systemic steroids) for 2–4 weeks.

Chronic intractable hand dermatitis may be treated with second-line agents such as azathioprine, methotrexate, ciclosporin, alitretinoin or phototherapy.

How can hand dermatitis be prevented?

Contact irritant hand dermatitis can be prevented by careful protective measures and active treatment. It is very important that people with atopic dermatitis are aware of the risk of hand dermatitis, particularly when considering an occupation.

What is the outlook for hand dermatitis?

With careful management, hand dermatitis usually recovers completely. A few days off work may be helpful. When occupational dermatitis is severe, it may not be possible to work for weeks or months. Occasionally a change of occupation is necessary.

Hand, Foot, and Mouth Disease (for Parents)

What Is Hand, Foot, and Mouth Disease (HFM)?

Hand, foot, and mouth disease (HFM) is a common viral infection that causes painful red blisters in the mouth and throat, and on the hands, feet, and diaper area.

HFM is contagious and easily spreads to others through contact with unwashed hands, feces (poop), saliva (spit), mucus from the nose, or fluid from the blisters. Kids under age 5 are most at risk for HFM, as infections are common in childcare centers, preschools, and other places where kids are in close quarters.

Besides the blisters, kids often have a fever for a few days and can get dehydrated because it hurts to swallow liquids. Symptoms usually clear up within a week and kids recover completely.

There’s no cure for HFM and no vaccine to prevent it, but your doctor can recommend home care to make your child more comfortable during recovery.

What Are the Signs and Symptoms of Hand, Foot, and Mouth Disease (HFM)?

The blisters caused by HFM are red with a small bubble of fluid on top. They often peel, leaving an ulcer, which is a sore with a reddish base. The soles of the feet and the palms of the hands may have a rash that can look like flat red spots or red blisters.

Occasionally, a pink rash may be seen on other parts of the body, such as the buttocks and thighs. However, some kids will have no problems other than sores in the back of the throat.

It can be hard for parents to tell if a child (especially a very young one) has HFM if sores are only inside the mouth or throat. Very young kids might not be able to communicate that they have a sore throat, but if a child stops eating or drinking, or wants to eat or drink less often, it’s a sign that something is wrong.

A child with HFM also might:

• have a fever, muscle aches, or other flu-like symptoms
• become irritable or sleep more than usual
• begin drooling (due to painful swallowing)
• only want to drink cold fluids

p1

How Is HFM Treated?

You can give acetaminophen or ibuprofen if your child is achy or irritable. Never give aspirin to children or teens, as it may cause a rare but serious illness called Reye syndrome.

Cold foods like ice cream, smoothies, and popsicles also help by numbing the area, and will be a welcome treat for kids who have trouble swallowing (and even those who don’t!). Avoid hot drinks, sodas, and acidic food (citrus juice, tomato sauce, etc.) because they can make the pain worse.

Kids with blisters on their hands or feet should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and pat dry. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection and cover it with a small bandage.

Make sure your child drinks plenty of fluids to stay hydrated. Call your doctor if your child remains very irritable, can’t be comforted, is sluggish, or seems to be getting worse. Also call if you see signs of dehydration, like a dry or sticky mouth, sunken eyes, or decreased urine output.

Can Hand, Foot, and Mouth Disease (HFM) Be Prevented?

To prevent the spread of HFM, keep kids home from school and childcare while they have a fever or open blisters on the skin and in the mouth.

Hand washing is the best protection. Remind everyone in your family to wash their hands well and often, especially after using the toilet or changing a diaper, and before preparing or eating food. Shared toys in childcare centers should be cleaned often with a disinfectant because many viruses can live on objects for a few days.

Hand-Foot Syndrome or Palmar-Plantar Erythrodysesthesia

Hand-foot syndrome is also called palmar-plantar erythrodysesthesia. It is a side effect of some cancer treatments. Hand-foot syndrome causes redness, swelling, and pain on the palms of the hands and/or the soles of the feet. Sometimes blisters appear. Hand-foot syndrome sometimes happens elsewhere on the skin, such as the knees or elbows. But this is less common.

Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care. Talk with your health care team about any symptoms you have. Make sure you bring up any new symptoms or changes in your symptoms.

Symptoms of hand-foot syndrome

Symptoms of mild or moderate hand-foot syndrome include:

• Redness similar to a sunburn

• Swelling

• A feeling of tingling or burning

• Tenderness or sensitivity to touch

• Tightness of the skin

• Thick calluses and blisters on the palms of your hands and soles of your feet

Symptoms of severe hand-foot syndrome include:

• Cracked, flaking, or peeling skin

• Blisters, ulcers, or sores on the skin

• Severe pain

• Difficulty walking or using your hands

Causes of hand-foot syndrome

Some cancer drugs affect the growth of skin cells or small blood vessels in the hands and feet. This causes hand-foot syndrome. Once a drug is out of the blood vessels, it damages the surrounding tissues. This causes symptoms that range from redness and swelling to problems walking.

Some drugs are more likely to cause hand-foot syndrome than others. Types of chemotherapy that can cause this syndrome include:

• Capecitabine (Xeloda)

• Cytarabine (available as a generic drug)

• Docetaxel (Taxotere)

• Doxorubicin (available as a generic drug)

• Fluorouracil (5-FU)

• Floxuridine (available as a generic drug)

• Idarubicin (Idamycin)

• Liposomal doxorubicin (Doxil)

• Paclitaxel (Taxol)

• Vemurafenib (Zelboraf)

Targeted therapies that are more likely to cause hand-foot syndrome include:

Not everyone who takes these medications develops hand-food syndrome. The severity of hand-foot syndrome can be different for everyone. Even people taking the same drug for the same form of cancer may not have the same symptoms.

Preventing and managing hand-foot syndrome

Hand-foot syndrome is usually worse during the first 6 weeks of treatment with targeted therapy. With chemotherapy, it usually appears after 2 to 3 months.

If you notice early signs of hand-foot syndrome, or if you notice your symptoms worsening, call your doctor’s office. Your health care team may need to change your treatment or help you manage the symptom. The following tips may help:

• Limit the use of hot water on your hands and feet when washing dishes or bathing.

• Take cool showers or baths. Carefully pat your skin dry after washing or bathing.

• Cool your hands and feet. Use ice packs, cool running water, or a wet towel for 15 to 20 minutes at a time. Avoid applying ice directly to the skin.

• Avoid sources of heat, including saunas, sitting in the sun, or sitting in front of a sunny window.

• Avoid activities that cause force or rubbing on the hands or feet during the first 6 weeks of treatment. This includes jogging, aerobics, and racquet sports.

• Avoid contact with harsh chemicals used in laundry detergents or household cleaning products.

• Avoid using rubber or vinyl gloves without a liner to clean with hot water. Rubber traps heat and sweat against your skin. Try using white cotton gloves underneath rubber gloves.

• Avoid using tools or household items that require you to press your hand against a hard surface. Examples include garden tools, knives, and screwdrivers.

• Gently apply skin care creams to keep your hands moist. Avoid rubbing or massaging lotion into your hands and feet. This type of movement can create friction.

• Wear loose fitting, well-ventilated shoes and clothes so air can move freely against your skin.

• Try not to walk barefoot. Use soft slippers and thick socks to reduce friction on your feet.

• Consider visiting a podiatrist to remove any thick calluses and thick nails before you begin cancer treatment. A podiatrist is a doctor who specializes in conditions of the feet. He or she can also recommend products that lower friction and put less pressure on the feet.

Treating hand-foot syndrome

When taking medications known to cause hand-foot syndrome, topical anti-inflammatory medications may help. These include corticosteroid creams such as clobetasol (multiple brand names) or halobetasol (Ultravate). In addition, your doctor may lower your chemotherapy dose or change your chemotherapy schedule. Your doctor may need to temporarily stop your chemotherapy until the symptoms of hand-foot syndrome get better.

The following options can be used to treat hand-foot syndrome:

• Topical pain relievers, such as lidocaine (multiple brand names). These are used as a cream or a patch over painful areas in the palms and soles.

• Topical moisturizing exfoliant creams are available, either over the counter or through your doctor. Those containing urea, salicylic acid, or ammonium lactate are most useful.

• Pain relievers, such as ibuprofen (multiple brand names), naproxen (multiple brand names), and celecoxib (Celebrex). Tell  your doctor if you are already taking any of these or other non-steroidal anti-inflammatory drugs (NSAIDs).

• Ice packs under the hands and feet while chemotherapy is being given to prevent hand-foot syndrome from paclitaxel, docetaxel, or doxorubicin.

Related Resources

Skin Conditions

Side Effects of Chemotherapy

Is my skin rash a COVID-19 symptom?

By Dr. Veronique Bataille and Dr. Justine Kluk

Reports that first came from China and then from Europe have shown that the skin can be affected by SARS-COV-2 (the virus that causes COVID-19) in up to 20% of cases. The virus triggers a number of immune reactions so it is no surprise that the skin is involved. 

The issue is that COVID can cause a wide variety of skin signs and symptoms, which is why there has been a delay in recognising that these various skin rashes were linked to the virus. 

In this blog we will focus on the three main types of skin rashes associated with COVID: urticaria (hives), erythemato-papular rash (described as a red bumpy rash) or erythemato-vesicular rash (described as chicken pox-like rash), and chilblains. 

Urticaria

These rashes can present quite early on in the infection, but can also last a long time after, when the patient is no longer contagious. The rash appears as sudden raised wheals on the skin which come and go quite quickly over hours and are usually very itchy. It can involve any part of the body. If it affects the face, it can cause swelling of the lips and eyelids. The eruption can also start with intense itching of the palms or soles. It is usually treated with antihistamines. If the patient has lip swelling, it is important to check that there is no difficulty in breathing or wheezing as this would need urgent medical attention. 

Figure 1: Acute urticaria caused by COVID with itchy wheals all over the body.Fig 2: Swollen lip caused by urticaria-type reaction in individual with COVID-19 infection.

Erythemato-papular or erythemato-vesicular rash

An erythemato-papular rash (described as a red bumpy rash) or erythemato-vesicular rash (described as chicken pox-like rash) rash is different from urticaria as it persists for days or weeks. It appears as red and bumpy areas which may occur anywhere on the body, but favours the elbows and knees as well as the back of the hands and feet. It can resemble bad prickly heat. In some cases, it is only tiny bumps all over the skin and the signs may be more subtle. This is also usually very itchy. The rash can also last well after the contagious stage is over and may also appear many weeks after the onset of the infection.

Fig 3. A bumpy and itchy rash on the upper back which some crusted areas where some small vesicles (blisters) were present.Fig 4: Rashes on the back of the feet or hands are common with COVID and may look like prickly heat. It is also common on the elbows and knees.

COVID fingers and toes

This is the most specific COVID rash as not many other skin conditions present in this way. It is known as chilblains and was relatively rare before COVID as it was seen mainly during cold spells and in people who had some problems with circulation in the fingers or toes. At the outset of COVID, however, dermatologists started to notice this type of rash much more than normal and in warm weather which seemed very unusual.

Eventually the link with COVID was made and this rash tends to be more common in younger people. The rash presents itself as reddish and purplish bumps on the fingers or toes and can affect many digits. This type of rash is usually present later in the infection and again may appear weeks after the onset of the viral infection. The fingers and toes are usually sore, but not itchy. When the rash recovers, the top layers of the skin may peel where the purplish bumps were. 

Fig 5: Purplish raised areas on the fingers is quite a specific rash for COVID and is usually painful.Fig 6: It can also cause multiple red and sore bumps on many fingers and it may be difficult to type.Fig 7: Purplish-red bumps and blisters are seen on the 3rd and 4th toes.

Eyes, lips and mouth

COVID can also cause sore and watery eyes. The lips may also feel sore and may be dry and scaly when they recover. Soreness inside the mouth can also occur. 

Fig 8: Sore lips with some whitish areas and scaling (also called cheilitis) can be caused by COVID.

The palm of the hand

Skin creases in atopic eczema

Whatever we may believe about reading palms, careful inspection of the palms of the hand in the surgery may shed light on a number of diagnoses. As in this patient with atopic eczema, the palmar skin creases on both hands are deeper and more marked than normal (hyperlinearity).

A number of studies have shown that these changes are more common in patients with atopic eczema than control patients with dry skin. These signs may also occur in patients with ichthyosis vulgaris.

Dermatitis of the hands

Patients with atopic eczema have a genetic basis for their hand dermatitis, but there is an increased risk for any patients who frequently immerse their hands in water, or are in contact with irritant substances. Some may be allergic to substances with which they are in contact while others, like this patient, have flares at the time of stress.

The patient should be advised to wear cotton-lined gloves when in contact with water or irritants, to apply emollients frequently and use topical corticosteroids to reduce the inflammation.

Tinea manuum

Tinea manuum is often misdiagnosed as dermatitis but, as in this case, it is usually unilateral. The patient notices a gradual area of dry, itchy, peeling skin on the palm and a ‘powdery filling’ in the skin creases. Sometimes blisters form. Skin scrapings for microscopy and culture should confirm the diagnosis of the fungal infection.

Patients may have other affected areas.

A topical antifungal preparation such as econazole or terbinafine will normally clear the condition but in widespread cases or if the nails are involved, an oral antifungal agent may be required.

Psoriasis of the palms

Psoriasis on the palms may also be misdiagnosed as dermatitis or confused with keratoderma. Clearly demarcated, thick, red scaly patches, often with deep, painful cracks are seen. If a search is made there are usually other signs, such as plaques on the extensor surfaces of the elbows and knees, the scalp or nail changes.

Frequent emollients may help to soften the skin and reduce the risk of fissures, together with a keratolytic such as salicylic acid or urea cream. Topical steroids, coal tar preparations, calcipotriol, acitretin, methotrexate or PUVA may also be used.

Pustular psoriasis of the palms

Some patients develop crops of sterile blisters as well as thickened, scaly patches of skin on the hands. The feet are also often similarly affected. The condition may persist for years, causing considerable discomfort and interfering with the patient’s quality of life.

This particular type of pustular psoriasis is more common in current or ex-smokers and patients should be advised to quit.

Treatment of pustular palmar psoriasis is the same as for straightforward palmar psoriasis.

Palmar keratoderma

Palmar keratoderma presents with a thickening hyperkeratosis and often a yellowish discolouration of the skin of the palms and the soles of the feet. It may cause discomfort or interfere with manual dexterity.

The condition may be genetically inherited or associated with inflammatory skin conditions, infections, medications, myxoedema or malignancy.

Treatment involves the plentiful use of emollients, keratolytics, topical retinoids, calcipotriol or systemic retinoids such as acetretin.

Hand, foot and mouth disease

This child presented with a rash on both hands of oval, yellowish vesicles surrounded by erythema. She had been a little off-colour and off her food in the last few days. On examination she had a similar rash on her feet and some small ulcers in the mouth.

The mother was reassured that hand, foot and mouth disease has nothing to do with the animal disease and would resolve spontaneously within a few days.

The condition is caused by coxsackie virus A16, has an incubation time of three to five days and is very infectious.

Erythema multiforme

Erythema multiforme (EM) often develops as a rash on the palms of the hands. These reddish, annular lesions have a slightly raised central area typical of target lesions.

Sometimes blisters will form which, if severe and widespread would suggest the more serious Stevens-Johnson syndrome.

The rash is symptomless or slightly itchy. The condition usually settles spontaneously in a few weeks. If necessary, oral antihistamines or topical corticosteroids may help to relieve symptoms. EM is due to a reaction to an infection or medication.

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Pompholyx Eczema | National Eczema Society

Pompholyx eczema

Jump to:

Introduction

What causes pompholyx eczema?

How is pompholyx eczema treated?

What are the treatments for severe pompholyx eczema?

Practical management tips

Introduction

Pompholyx eczema (also known as dyshidrotic eczema/dermatitis) is a type of eczema that usually affects the hands and feet. In most cases, pompholyx eczema involves the development of intensely itchy, watery blisters, mostly affecting the sides of the fingers, the palms of the hands and soles of the feet. Some people have pompholyx eczema on their hands and/or feet with other types of eczema elsewhere on the body. This condition can occur at any age but is usually seen in adults under 40, and is more common in women.

The skin is initially very itchy with a burning sensation of heat and prickling in the palms and/or soles. Then comes a sudden crop of small blisters (vesicles), which turn into bigger weepy blisters, which can become infected, causing redness, pain, swelling and pustules. There is often subsequent peeling as the skin dries out, and then the skin can become red and dry with painful cracks (skin fissures). Pompholyx eczema can also affect the nail folds and skin around the nails, causing swelling (paronychia).

What causes pompholyx eczema?

The exact causes of pompholyx eczema are not known, although it is thought that factors such as stress, sensitivity to metal compounds (such as nickel, cobalt or chromate), heat and sweating can aggravate this condition. Fifty percent (50%) of people with pompholyx have atopic eczema as well, or a family history of atopic eczema. Pompholyx eczema can coexist with fungal infections, so assessment should include checking for the presence of any fungal infection on the hands and feet.

Pompholyx eczema occurs on the palms of the hands, fingers and the feet – the skin in these areas is more prone to exposure to potential sources of irritation and aggravation. For this reason, pompholyx eczema can be debilitating and difficult to manage. It can also cause problems with employment.

The hands and feet, where pompholyx commonly occurs, are areas of the body that are also prone to contact dermatitis. This can take one of two forms – irritant contact dermatitis or allergic contact dermatitis.

A reaction could be the result of contact with potential irritants such as soap, detergents, solvents, acids/alkalis, chemicals and soil, causing irritant contact dermatitis. Or there could be an allergic reaction to a substance that is not commonly regarded as an irritant, such as rubber or nickel, causing allergic contact dermatitis. It is possible to have been in contact with a substance for years without any problems and then suddenly develop a sensitivity to it. If you identify a pattern, tell your healthcare professional as allergy patch testing may be appropriate.

Pompholyx may occur as a single episode, but for most people it is a chronic type of eczema that will come and go.

How is pompholyx eczema treated?

First, any obvious trigger for the pompholyx flare should be avoided as far as possible, especially in the case of a contact allergy.

Emollients

Emollients (medical moisturisers) are a first-line treatment and should be used for washing and moisturising. If your skin is weeping, oozing and crusting, a wet soak may be advised – usually a potassium permanganate soak under supervision (prescribed as Permitabs, which are dissolved in water to the strength of the colour of rosé wine) once or twice a week. Soak the hands and/or feet in this solution for approximately 15 minutes (preferably in an old bucket or washing-up bowl) and then rinse in water with emollients and pat dry. This treatment does stain your skin and the bath (in fact, everything it comes into contact with!) – hence the suggestion of an old bucket or washing-up bowl – so use it carefully! After using the soaks, continue to moisturise your hands and feet with emollients.

When the acute flare of pompholyx subsides, the soaks should be stopped (usually after 3-7 days). A leave-on emollient or an emollient soap substitute should be used for washing, since soap de-greases the skin and can also act as an irritant. It’s a good idea to carry around a small pot of emollient to use for hand-washing during the day, so you can avoid detergent hand washes. For more information and practical tips on emollients, please see National Eczema Society’s Emollients factsheet.

Topical steroids

Pompholyx eczema needs to be treated with topical steroids to treat active eczema by reducing inflammation. Topical steroids will reduce red, sore and cracked skin. Hands usually require stronger steroids (the skin of the palms is thick), so potent topical steroids are usually prescribed (moderately potent for children). They should be used for a short treatment burst – generally 2 weeks. For more information, see National Eczema Society’s Topical steroids factsheet. Topical steroids will need to be prescribed by your doctor or other healthcare professional. Topical steroids switch off the inflammatory response, but as they reduce the inflammatory process, the skin can become drier, so you will need to apply leave-on emollients frequently.

Treatments for infection

If your hands and feet are sore and weepy, and yellow crusting is present, you may have a bacterial infection. This will require a course of oral antibiotics, prescribed by your doctor or other healthcare professional.

What are the treatments for severe pompholyx eczema?

For severe pompholyx eczema, a dermatology referral may be required for treatment and/or diagnosing contact allergy (patch testing). Treatment may include a short course of oral immunosuppressant drugs. Alitretinoin (known as Toctino) is an oral treatment licensed for use in adults with severe chronic hand eczema (including pompholyx) that has not responded to treatment with potent topical steroids. Alitretinoin works by reducing the inflammation associated with eczema as well as damping down the response of the immune system. It is a capsule that is taken by mouth once a day with a meal for 12-24 weeks, depending on how the condition responds to the treatment.

Alitretinoin can only be prescribed by dermatologists or doctors with experience both in managing severe hand eczema and in the use of retinoids. The specialist will determine whether your hand eczema is severe by examining your hands and asking a series of questions about how the eczema affects your life. You will also need to be carefully monitored.

Retinoids are likely to cause severe birth defects if taken during pregnancy. This means that any woman with child-bearing potential must avoid becoming pregnant during treatment and for one month after stopping treatment – for example, by using two effective methods of contraception. The drug can only be prescribed if a pregnancy test is negative. Regular pregnancy tests will be taken during treatment.

You should not breastfeed while taking alitretinoin and for a month after completing treatment.

The most common side effects are headaches, dry lips and skin, and flushing. Other side effects include raised blood fats such as cholesterol, and decreased levels of thyroid hormone. Due to potential side effects, a lower dose will be prescribed if you are diabetic.

Phototherapy (UVB or PUVA), using either UVB or UVA rays administered by a special foot/hand light box, may be recommended if this treatment option is available locally to you. Assessment and treatment (2-3 times a week) would usually take place in a dermatology department. In some areas of the UK you may be loaned a light box so you can administer your treatment at home, although you will continue to be monitored by the dermatology department. Prior to treatment, your feet or hands might be coated in a light-sensitising solution called psoralen (the ‘P’ in PUVA). Phototherapy treatment usually continues for a few months until the pompholyx eczema has resolved.

Occasionally, for very severe outbreaks of pompholyx eczema, a short course of oral steroid tablets is prescribed.

Practical management tips

• Use lukewarm water for washing as very hot or cold water may irritate. Remember to use an emollient as a soap substitute, and avoid soap.
• Try to avoid direct contact with any detergents or cleansing agents, using cotton-lined gloves rather than rubber or plastic gloves alone. Be very careful about detergents etc. when doing any jobs in the home. When shampooing your hair, always wear cotton-lined gloves as above. If possible, when the pompholyx is active, ask someone else to do the shampooing for you – and the housework, too!
• If itchiness is interfering with sleep, sedating antihistamines may be helpful at night (but will cause unwelcome drowsiness if taken during the day). Remember, antihistamines in eczema aid sleep rather than actively treat itchiness.
• Large blisters may be gently drained by using a large sterile needle. Very gently make a small jagged tear in the blister (a pin-prick hole will not be effective as it will not release fluid and will seal up very quickly). Make sure that you do not remove the ‘roof’ of the blister – this protective layer of skin needs to stay in place, otherwise soreness can increase, healing can be delayed and there is a risk of infection.
• Tights, stockings, socks and gloves should be 100% cotton or silk if possible, as synthetic fabrics such as nylon are less absorbent than cotton and do not generally allow the skin to ‘breathe’ in the same way.
• Bandaging or wrapping the feet or hands can help to protect the skin. Alternatively, cotton or silk gloves or socks can be worn. Covering the skin can bring some relief as well as ensuring that creams and ointments are given the maximum opportunity for absorption. If paste bandages or wet wraps are used, you should discuss with a healthcare professional their suitability, application technique and how to use them with creams and ointments. Any weeping blisters, however, should be covered with a non-stick dressing, to prevent tearing the blister roof.
• If it is difficult to keep topical steroids on the hands and feet, another option is to use a steroid impregnated tape, which would need to be prescribed by your doctor.
• If you have painful cracks and fissures post-blister stage, Extra Thin Duoderm is a helpful hydrocolloid dressing that you can cut to shape and put on cracks and fissures. However, you should speak to your healthcare professional before using Duoderm on an area you are treating with topical steroids, because when you closely cover skin that is being treated by a topical steroid, this will make the topical steroid more potent.
• Footwear should be kept dry and permeable to the air. Avoid plastic or rubber shoes, trainers and any other type of footwear likely to cause sweating – leather linings are preferable to synthetic.

To obtain the information on this page in a PDF format, please download our Pompholyx eczema factsheet, below.

Related Documents

Rise in Hand Eczema, Rashes Due to Coronavirus Handwashing, Say Dermatologists

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In the weeks since news of the new coronavirus, COVID-19, pandemic has intensified, the phrase “wash your hands” has quickly become a common refrain. The Centers for Disease Control (CDC) has advised Americans to wash their hands “often,” using soap and water and counting at least 20 seconds each time. The good news is that dermatologists say their patients are following these guidelines and washing their hands many times per day — the reason they can tell is that those patients are making appointments to address itchy, red, irritated hands.

“I am seeing more patients coming in recently with rashes on the hands from over-washing,” Joshua Zeichner, director of cosmetic and clinical research in dermatology at New York City’s Mount Sinai Hospital, tells Allure. As a result of the constant exposure to oil-stripping soap and warm water, eczema and dermatitis rashes are on the rise. “It is important to treat these rashes because, in addition to being itchy, inflamed, or raw, the skin is at risk for developing an infection,” he says.

Even in the best of times, dermatologists see a rise in hand irritation during the colder months. “Most winters, we are washing our hands often to prevent infections, including the cold and flu, but this year with coronavirus, there is a combination of even more frequent handwashing and the constant use of alcohol-based hand sanitizers,” says Shari Marchbein, a board-certified dermatologist and clinical assistant professor of dermatology at NYU School of Medicine. “The excessive washing strips the skin of healthy fats and oils known as sebum, and that dehydrates the skin and causes eczema.”

Dry skin is caused by an impaired skin barrier and dysfunction or deficiency in the necessary healthy fats in the top layer of the skin, says Marchbein. That protective layer is “essential to normal skin function,” which means skin will grow irritated if the barrier is disturbed.

“Those with extremely dry skin from over-washing, under-moisturizing, or genetic predisposition can develop eczema,” she says. “Since the protective lipid layer is responsible for keeping moisture in and bacteria and irritants out, dry skin often presents with redness, flaking, itching, and even painful cracks that can leave us susceptible to infections. Any break in the skin can do this.”

90,000 Red spots on the palms

Many painful conditions of a person manifest themselves on the skin. Including red spots on the palms indicate the presence of any trouble in the body. For the successful elimination of a skin defect, it is necessary, without delay, to find out the cause of its occurrence. The examination should begin with a consultation with a dermatologist.

Epidemiology of red spots on the palms

The epidemiology of this disease is ambiguous; for a long time it was considered as a purely professional one.According to foreign studies, about 30% of the adult population, mainly in developed countries, suffers from allergic contact dermatitis. In addition, according to German scientists, no more than 40% of patients with such problems apply to medical institutions. Among children, the prevalence of allergic contact dermatitis is lower, however, it was diagnosed in one fifth of all children and adolescents who sought medical help for dermatitis.

Causes of red spots on the palms

Rashes on the palms can be triggered by many factors.

Most often, contact dermatitis manifests itself this way. It can be allergic and simple (burns, frostbite, scuffs). The reasons for the simple are almost always obvious; when they are eliminated, dermatitis also disappears. Allergic occurs in the place that has been in direct contact with the substance that caused the allergy. For example, with cleaning agents, detergents. This can cause sensitization to cold (cold allergy). Rashes appear immediately after a sharp cooling of the skin on the hands or feet.Less commonly, an allergic rash on the palms and / or feet can be caused by a food or drug allergen. In the pathogenesis of sensitization in these cases, mainly T-lymphocytes, not antibodies, are involved. Microscopic examinations of samples from the lesion show high concentrations of lymphocytes and other immune cells that have moved from the bloodstream to places of redness.

Risk factors for red spots on the palms

Risk factors for the appearance of red spots – nervous strain or severe stress, decreased immunity.

The same factors cause relapses of dyshidrotic eczema. It is not a contagious chronic itchy condition. Its causes have not yet been fully elucidated; they presumably include allergic manifestations caused by household chemicals and food products, and a hereditary predisposition. Dyshidrotic eczema can be observed not only on the skin of the palms and feet, but also on the back. Most of those who applied for this disease are under 40 years old, among them are patients of both sexes.The pathogenesis of dyshidrotic eczema is not actually associated with sweating disorders as previously thought. A family history of 50% of patients has a predisposition to allergic reactions. Risk factors, in addition to emotional stress, are called high temperature and humidity.

Rashes can be infectious (for example, beginning lichen), viral (herpes), parasitic (scabies) in nature. This rash, which usually first appears on the palms of the hands, spreads quickly enough to other parts of the body.It is transmitted by contact with a sick person, a fungal infection (lichen) can also be infected from a sick animal. Herpes is widespread, 90% of the adult population of the planet have antibodies to it.

A bright raspberry rash localized only on the palms or feet – erythrosis (Lana’s disease). Itching is not typical for this disease. Such rashes should be well known to the patient, since the tendency to them is inherited from close relatives. The palms, as well as the feet, have an extensive network of arterial and venous vessels – nature has provided for a good blood supply to this part of the body.In the pathogenesis of the disease, the main role is played by hereditary disorders in the vessels that interact between the venous and arterial systems – anastomoses. Through these vessels, with an increase in blood pressure, blood is discharged into the venous bed, if the anastomoses are narrowed or completely impassable, then the discharge of blood is disrupted, arterioles and capillaries constantly work in overload mode. This contributes to their constant expansion and the appearance of red spots. The disease is quite rare, manifests itself both from birth and at a later age under the influence of factors provoking its development.Men and women get sick equally often, in one family the disease manifests itself in all or almost all of its members.

Dysfunction of the heart muscle, vegetative-vascular dystonia causes seizures, leading to a decrease in vascular tone and the appearance of pinpoint red spots on the palms. They do not itch, do not hurt, and go away with the attack.

Diabetes mellitus is a risk factor for skin infection. Changes in hormonal levels during puberty, during pregnancy, taking hormonal drugs can also cause rashes; the rapid growth of itchy rashes on the palms is a signal for a visit to the oncologist.

Symptoms of red spots on the palms

Since red spots on the palms can be caused by a variety of reasons, the symptoms also have some differences.

The clinical signs of allergic contact dermatitis are similar to those of the acute stage of eczema. The first signs are the appearance of sufficiently large redness, later on their background small multiple bubbles begin to form. Bursting and getting rid of the contents, they are exudative red spots on the surface of the skin, drying out, they can become covered with scales and crusts.The main focus is located where contact with the allergen occurred. Red spots on the palms itch, making it difficult to sleep and stay awake. Sometimes itching precedes the appearance of a rash – palms itch and red spots appear, as if from scratching. Contact allergic dermatitis can be localized on the feet if you had to walk barefoot on the substance that causes the allergy. Since the body is sensitized to the effects of the allergen as a whole, the appearance of secondary foci can occur anywhere in the body, very distant from the primary focus.Secondary lesions may appear as red nodules, vesicles, specks, redness, and swelling. Allergic dermatitis can also look like one red itchy spot on the palm (usually at the site of contact with the allergen), single and massive rashes can appear on the back of the hands and feet.

Dyshidrotic eczema is symptomatic of contact dermatitis. The first signs are the appearance of grouped small, approximately millimeter-sized, deeply located vesicles, sometimes with vesicles.Newly appeared small red spots on the palms itch violently. Later, they merge, burst, forming erosive surfaces that flake and crack. This stage is already accompanied by pain. It is localized in 80% of cases on the hands, sometimes on the soles, red spots on the palms and feet itch. First, the surface of the skin between the fingers, palms and the plantar of the foot is affected, then the rash can spread to the dorsum.

The first signs of erythrosis (Lana’s disease) – a significant number of bright rashes of a rich crimson color appear on the palms.At the same time, they appear on the feet, however, they are noticed there later. The spots are not sore or itchy. On closer inspection, you can see that the spots are not solid – these are small dots concentrated very close. Such accumulations are localized on the fingers and between them, the palmar tubercles under the extreme fingers – the little finger and the thumb. The border with healthy skin is sharply defined and located along the lateral surface of the hands and feet. Rashes with erythrosis are never located outside the hand or foot.This pathology is not characterized by increased sweating on the inner surface of the palms and feet, which is used to differentiate it from similar diseases.

If the hands of the downward hands turn red and small white spots appear on them, this indicates a problem with capillary circulation, but special treatment is usually not prescribed. If a person has red palms with white spots forming a marble ornament, then this indicates circulatory disorders.

Having found red scaly spots on the back of the palm, one can assume the presence of psoriasis, by the way, this disease also has a palmar-plantar form. Lichen and other infectious skin diseases can also begin on the hands, as our hands most often come into contact with infected objects. Such symptoms should be an incentive for referring to a dermatologist.

Lichens can be localized on the hands, for example, microsporia (ringworm).Although the palms, and even more so the feet, are extremely rarely affected, this cannot be completely ruled out. You can get infected not only from a sick animal, but also from a person. First, a red pimple appears, which itches, but not too much, grows and brightens in the center, dry scales begin to form there. Along the edges are small red papules, forming a clear border. The formation gradually increases, along the edge of the spot, a limiting ridge is formed, consisting of vesicles, nodules and crusts.

Infection with scabies caused by a scabies mite can be assumed by detecting characteristic eruptions that itch intensely, especially at night or after taking a bath (shower). The rash is characterized by thin, twisting light lines connecting the entrance and exit of the tick. At the ends there are small specks or bubbles, which sometimes merge into plaques with exudation. On the skin of the palms, these rashes are localized between the fingers. You need to look for the same rashes. Ticks love thin, delicate skin, flexion areas of the arms, external genitals, abdomen, sides, folds of skin.They never settle on their backs. Children have palms, feet, buttocks, face and head.

Red spots on the palms and fever in a child may appear at the onset of infectious diseases – measles, chickenpox, rubella, scarlet fever. Contact allergic dermatitis can sometimes be accompanied by a fever. Adults are also not immune from childhood illnesses, especially since in adults, childhood illnesses often occur in an atypical form and are quite difficult. The presence of such symptoms should be alarming and force you to immediately consult a doctor.

Having noticed red spots on the palms of a child, parents, as a rule, seek medical help. Basically, rashes with infectious diseases are localized not only on the palms, they appear after the temperature rises (measles, scarlet fever) and other symptoms. So, for measles, photophobia is characteristic – the child asks to draw the curtains on the windows, scarlet fever is a type of sore throat and a rash usually complements the symptoms. Chickenpox and rubella can occur in children in a mild form without an increase in body temperature, and the rash is localized throughout the body, and with chickenpox it also itches a lot.

Allergic dermatitis on the palms appears after contact with an allergen, which can be, in principle, any substance. Most often these are chocolate, citrus fruits, medicines, plants (including domestic ones), animal hair (most often cats), insect bites, cosmetics and household chemicals. A rash that is deep red, itchy, may be accompanied by respiratory distress.

Lana’s disease often manifests itself already in childhood. Diseases of the circulatory and hematopoietic organs, accompanied by a hemorrhagic rash, may appear as red spots on the palms.

Failure to comply with hygiene rules in young children manifests itself as prickly heat, diaper rash, dermatitis. The palms are not the most characteristic part of the body for such rashes, but it cannot be ruled out.

Complications and consequences of red spots on the palms

The consequences and complications of rashes, especially itchy ones, are fraught with an associated secondary infection. Sometimes such rashes, which appeared as an allergic reaction, quickly go away on their own, with the exclusion of contact with the allergen.However, if the spots persist, you should immediately contact a dermatologist so as not to aggravate the course of the disease and avoid possible complications, since the appearance of spots on the palms signals a problem in the body.

Diagnosis of red spots on the palms

Diagnosis is carried out on the basis of a complete examination of the skin and mucous membranes, based on typical signs of the disease. Laboratory tests: bacterial cultures, urine and blood tests – biochemical and clinical, in some cases a blood test for hormones, remoprobes, immunological tests is done.A medical history is compiled taking into account hereditary predisposition. Instrumental diagnostics are prescribed: ultrasound of internal organs, skin biopsy, microscopy of scrapings and cultures. To differentiate with diseases accompanied by a similar clinic, differential diagnosis is carried out. For example, with a preliminary diagnosis: dyshidrotic eczema, contact dermatitis, fungal lesions (dermatophytosis of the feet), palmar-plantar psoriasis, neurodermatitis localized on the palms and feet, eczematides, epidermomycosis, spongiosis, scabies and some other skin diseases should be excluded.

After analyzing complex data, including a detailed medical history, clinical examination data, as well as the results of laboratory and instrumental studies, the doctor can make the correct final diagnosis and prescribe treatment.

Treatment of red spots on the palms

In dermatology, when symptoms are similar, diseases can have completely different etiologies – from infection with microorganisms to autoimmune aggression, therefore, treatment methods in most cases are based on symptoms.Only certain diseases require radical treatment aimed at eliminating the cause of their occurrence.

Most often, with symptomatic therapy, external drugs are used to relieve itching, pain, and eliminate rashes, much less often oral medications or injections are used.

In case of relapses of the disease, water procedures with the use of soap, foam and shower gels are not recommended in order to avoid skin irritation. It is undesirable to use household chemicals, at least you need to wear gloves.It is advisable to avoid prolonged exposure to unfavorable environmental conditions – solar radiation, rain, wind, snow. Do not wear synthetic, fur or wool products to irritated areas. From the patient’s diet, foods that most often cause allergies are excluded: citrus fruits, chocolate, coffee.

If red spots on the palms are caused by contact dermatitis, you need to identify and remove the irritant, after which in most cases it goes away on its own or requires simple rehabilitation to eliminate residual irritation on the skin.Patients with an immediate allergic reaction often do not need any therapeutic action at all, since the inflammation disappears after the contact with the allergen is eliminated as quickly as it arose. The patient must simply know his allergens and eliminate the possibility of contact with them throughout his life. It should be borne in mind that over time, the range of substances that cause allergies in a given person usually expands.

With more complex forms of allergic contact dermatitis, drug therapy is carried out, mainly consisting in the use of local antihistamine or hormonal ointments, lotions with drugs.In the vesicular-bullous stage of allergy, the blisters on the patient’s body are recommended to be opened, while the upper part (cap) of the bladder is not removed, but impregnated with an antiseptic and left in place. Modern techniques recommend using epithelial ointments in such cases.

Patients with a severe form of the disease are prescribed potent drugs both externally and internally, and in order to increase the absorption of the drug, hermetic dressings are used. When dressing, the damaged skin is treated with a salt solution and ice is applied to it.

Difficulties are presented by cases of occupational allergic contact dermatitis, when a radical change in the type of activity is often required to cure the patient.

Treatment of allergic contact dermatitis begins with weaker external preparations, if there is no effect after a few weeks, they switch to stronger ones. They finish the fight with residual effects, again using weaker means. When prescribing an external agent, the doctor usually takes into account the factor that ointment works better on dry surfaces with cracks, and cream works better on wet surfaces.If a secondary infection is suspected, your doctor may prescribe antibiotics, which can cause allergies. You do not need to try to eliminate it yourself, you should consult a doctor to adjust the appointment.

Ointments (creams, gels) and other external preparations are applied to dry, clean skin with a thin layer, without rubbing.

Fenistil gel (active ingredient – dimethindene maleate, blocker of H1-histamine receptors). The drug reduces the production of histamine in the body, eliminates itching, irritation and other symptoms of an allergic reaction.Promotes strengthening of capillary walls, has anesthetic and healing effect.

It is characterized by speed of action, noticeably improves the condition almost immediately, the highest concentration at the site of application can occur within an hour. 10% of the active component is absorbed into the systemic circulation. It is used for itchy rashes of various etiologies, including simple and allergic contact dermatitis.

Contraindicated in cases of sensitization to other ingredients of demitedenum, newborns, pregnant women in the first three months, with prostate adenoma, angle-closure glaucoma.

It is used two to four times a day, in severe cases accompanied by severe itching or extensive lesions, it can be combined with taking Fenistil drops or capsules.

May cause adverse reactions at the site of application.

For allergic diseases with an attached secondary infection, the doctor may prescribe Lorinden C ointment. This is a combined preparation containing the glucocorticosteroid flumethasone pivalate, which relieves inflammation, itching, exudation and other allergy symptoms, in combination with iodochloroxyquinoline, which has a bactericidal and fungicidal effect.Can be used by pregnant and lactating women in small areas. It is not prescribed for syphilitic and tuberculous skin lesions, oncological skin diseases, the consequences of vaccination and sensitization to the components of the drug.

Ointments that help accelerate tissue regeneration – Actovegin, Solcoseryl, the active ingredient of which is a calf blood extract devoid of a protein component.

Solcoseryl ointment is a biogenic stimulator of cellular metabolism, stimulates the absorption and assimilation of oxygen and glucose by cells of the damaged epidermis, repairs and maintains its viable state.It prevents the formation of trophic changes, accelerating the process of restoration of the epithelial layer. Once or twice a day, a thin layer is lubricated with lesions, can be used in bandages. May be used by pregnant and lactating women.

Actovegin ointment is an activator of intracellular metabolism, stimulates the absorption and assimilation of oxygen and glucose by cells of the damaged epidermis, repairs and maintains its viable state. It additionally improves blood circulation.Two or three times a day, a thin layer is smeared with lesions. Use by pregnant and lactating women – with caution. May cause side effects in the area of ​​application.

To get rid of residual effects, Methyluracil ointment with the same active ingredient is also prescribed. Stimulates the processes of reproduction of leukocytes and, to a lesser extent, erythrocytes, which leads to cellular renewal, accelerated healing and activation of the protective functions of the skin. It is prescribed to persons with leukopenia with long-term non-healing skin lesions, a doctor prescribes a treatment regimen.Contraindicated in malignant diseases of the blood and bone marrow.

Therapy with non-hormonal ointments is usually long, hormonal ointments are used no more than one to two weeks. Ointments with glucocorticosteroids cause many side effects, including vasodilation, atrophy and depigmentation of the skin at the site of application.

Dyshidrotic eczema is treated by conducting all kinds of examinations and finding out the provocateur of this condition. After diagnosis, treatment is started: antihistamines and anti-inflammatory drugs are used internally and externally, in severe cases, hormonal drugs and ointments.Diuretics, hemodesis are prescribed to prevent the side effects of glucocorticosteroids.

Small lesions in the initial stage are treated with ointments with Naftalan oil, sulfur, birch tar; with an attached fungal infection – the drug Fukortsin, produced in the form of a solution and having a wide range of antimicrobial activity, including against fungi. Contraindicated in allergic dermatoses, children 0-11 years old. Apply to the affected skin one to three times a day, apply until the symptoms disappear.May cause overdose effects: dizziness, nausea, weakness, dyspepsia. Contraindicated in case of sensitization, does not apply on significant body surfaces.

Elidel cream copes well with eczema of all types; its effectiveness can be compared with strong hormonal ointments. The active ingredient is pimecrolimus, an ascomycin derivative. Provides selective inhibition of production and release of pro-inflammatory factors from T-lymphocytic and mast cells.And also suppresses the secondary immune response of T-helpers of the epithelium. Does not affect the processes of renewal of the skin, does not cause their atrophy. It helps well with itching, inflammation – exudation, hyperemia, thickening of the skin. Can be used on surfaces of any area, pregnant women and children from 3 months of age. The cream is carefully treated with diseased skin two or more times a day.

May cause overdrying of the skin; after taking water procedures, a moisturizer is applied before treatment.Contraindicated in case of sensitization to the components, with skin infection, with the possibility of malignant degeneration.

For non-infectious genesis of dyshidrotic eczema, Advantan ointment with the active ingredient methylprednisolone is also used. The ointment inhibits accelerated cell division, reduces the manifestations of inflammation – redness, rash, swelling, itching. Available for dry, normal and oily skin. Contraindicated in case of sensitization to the active substance, infection with viruses, tuberculous and syphilitic skin lesions.

The treatment of areas with rashes is carried out once a day, the duration is not more than four months, for children – no more than one.

Side effects are local in nature – from rashes to atrophy of the skin surface, folliculitis, hyper hair.

Elokom ointment with the active substance mometasone furoate, which is active against pro-inflammatory mediators, promotes the binding of histamine and serotonin, strengthens the walls of blood vessels, removes edema, dries and reduces exudation.It can penetrate into the general circulatory system, causing side effects common to all glucocorticosteroids. A daily one-time treatment of the affected skin areas is usually recommended. Hormonal ointments are not recommended for pregnant and lactating women.

With Lana’s disease, which does not cause discomfort (itching, exudation), treatment may not be prescribed. In some cases, glucocorticosteroids are used, orally and topically, to dilate blood vessels, improve additional blood circulation, and lower pressure in the arterial bed.This reduces the redness of the palms and the stress on the blood vessels.

With an infectious, viral or parasitic etiology of red rashes on the palms and feet, a specific treatment is prescribed to eliminate the causative agent of the disease. The treatment regimen and drugs are prescribed by the doctor.

For example, for lichen and other fungal infections, Fukortsin solution, Lamisil spray and cream, Lamikon spray and cream are prescribed.

Lamisil (Lamikon) spray and cream have an active ingredient – terbinafine.Its action is to interrupt the production process of the main component of the fungal cell membrane – ergosterol. The fungicidal action of the preparations consists in inactivation of the enzyme squalene epoxidase, the catalyst of the third, penultimate stage of ergosterol biosynthesis. Its deficiency with the simultaneous concentration of squalene in the membrane kills fungal cells.

Squalene epoxidase of human skin cells is not susceptible to terbinafine, which explains the selective effect only on fungal cells.

These drugs have a fungicidal effect on the causative agents of epidermophytosis, trichophytosis, microsporia, pityriasis versicolor, candidiasis, as well as on dermatophytes, aspergillus, cladosporiums, scopulariopsis, fungicidal or fungistatic – on yeast fungi of various types.

The manifestations of the systemic effect of the drug are insignificant.

Studies have not revealed the adverse effects of terbinafine on the intrauterine development of the fetus, but during pregnancy it is prescribed only for strict indications.Terbinafine is found in breast milk, so it is better to refrain from using it during breastfeeding.

Contraindications for use – allergy to the ingredients of the drug; period of breastfeeding; age up to 3 years.

Use with caution in cases of: impaired liver and / or kidney function; alcoholism; neoplasms; disorders of metabolic processes, hematopoiesis processes, patency of the vessels of the extremities.

Recommended duration of use: for dermatomycosis and epidermophytosis, the lesion is irrigated once a day for one week; with pityriasis versicolor – twice a day for one week.

For the treatment of fungal lesions, especially those located in places covered with shoes, the form of release of the drug is very important. The fatty components of ointments and creams, which are mainly prescribed for topical use, can cause a greenhouse effect in the area of ​​infection, exacerbation of the inflammatory process and its further spread. In order to prevent such a development of the disease, antimycotics in the form of a spray are used to treat the lesion site.In case of damage to the palms, you can use both ointments and sprays.

For herpetic lesions of the skin of the palms, Acyclovir cream is used. It has an antiviral effect, blocking the process of viral DNA synthesis, and also immunomodulatory. This cream is intended for the treatment of rashes caused by the herpes virus. Herpes is treated by smearing the rash five times a day with an interval of one hour. Repeat this procedure for five to ten days. This drug is well tolerated, although local side effects may also occur.

For scabies, antiparasitic ointments, such as benzyl benzoate, are usually prescribed. The treatment regimen is prescribed by the doctor.

For bacterial skin lesions, ointments with antibiotics that are active against the identified microorganisms are used.

If rashes of any etiology are accompanied by severe itching that interferes with the patient’s night sleep, the doctor may prescribe sedatives or antihistamines with sedative components.

Vitamins A and E are prescribed to reduce the permeability of the vascular membranes, accelerate the processes of restoration and renewal of the skin surface, stabilize the hormonal background and systemic action on the body.

As part of the complex therapy, physiotherapy is prescribed. This can be acupuncture, laser therapy, high frequency currents or magnetic waves, cryotherapy, electrosleep, ultraviolet irradiation, paraffin therapy.

Alternative treatment for red spots on the palms

Alternative treatment of red spots on the palms can be used rather in a complex of therapeutic measures, it does not exclude a visit to the doctor, diagnosis.As an independent treatment, it can only help in cases of mild non-infectious skin lesions.

Spots of allergic origin at the very beginning of their appearance can be cooled with water or a cold compress to relieve itching and swelling; for the same purpose, they can be treated with a cotton swab abundantly moistened with vodka or alcohol, after which the swab can be held at the site of the lesion for ten minutes.

Before going to bed, it is recommended to immerse your hands daily for 15-20 minutes in warm water, combined in a bath with a decoction of medicinal herbs: string, chamomile, celandine, sage, oak bark in equal proportions.This procedure soothes inflamed skin, disinfects and relieves itching.

You can make ointments:

• Mix 5 milliliters of whole cow’s milk (homemade) with the same amount of purified pharmacy glycerin, add rice starch until a homogeneous gruel is obtained – treat rashes with this ointment at night and rinse off in the morning;
• Mix a quarter cup of fresh cranberry juice with 200 g of petroleum jelly, treat the rash to eliminate itching and irritation;
• Crush 25 fresh leaves of St. John’s wort in a wooden mortar, place in a glass jar, pour in a quarter liter of homemade sunflower seed oil, cover and leave for at least 15 and no more than 20 days, shaking occasionally.Then the composition is filtered, stored in a cool place in a dark glass container, well sealed. Treat the affected skin. Sun exposure to the affected and treated areas is undesirable.

For dyshidrotic eczema, the following recipes are recommended:

• wipe the rash with horseradish tincture: four teaspoons of which are steamed 0.5 liters of boiling water and insisted for two hours, cool and use, or a tincture of blackberry leaves, which is crushed (100 g), steamed with two liters of boiling water and infused;
• lubricate palms and feet with sea buckthorn oil 3-4 times a day;
• lotions with eucalyptus tincture: steam four tablespoons of crushed dry eucalyptus leaf? liter of boiling water, darken for half an hour over low heat, stirring, cool and strain.

Blackcurrant ointment. Thoroughly chop two currant branches and grind into powder, add 200 g of butter there. Heat in a water bath, stirring, for at least five minutes. The cooled ointment is ready for use.

With Lana’s disease, you can make vasodilating applications with herbal balm prepared according to the following recipe: make an herbal collection from the same amount of dry crushed herbs: sage, St. John’s wort, string, plantain, chamomile.Brew a tablespoon of the herbal mix with a glass of boiling water and leave for a long time to make a gruel. Heat this gruel to t

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90,000 Types of rashes on the palms and hands of a child and an adult: photos and causes

Contents of the article

Any person at least once in his life suffered from the appearance of a rash. A red rash on the hands can arise from many factors: biochemical, physiological and anatomical, differ in varying degrees of pain sensitivity.

It must be understood that the appearance of rashes on the skin is not only an aesthetic problem that must be eliminated due to an unpleasant appearance, but often the body, thus, tries to tell its owner about the presence of very serious failures.

At the first signs of a rash, you should immediately consult a doctor so that he diagnoses and the reasons for the spread of the red rash on the hands and recommends methods of treatment.

Varieties of red rash on the hands

Normal appearance of the skin reflects the internal health of a person, but as soon as malfunctions occur in the body, they appear first of all on the dermis.Peeling, red rash, and many other symptoms can indicate internal disorders of the body.

That is why there are a number of different types of red rash, which differ in appearance and causes of occurrence:

• Bubble – a small cavity filled with serous fluid inside, has a size of no more than 1 centimeter. Subdivided into single and multi-chamber. After their opening, ulcers and erosion remain on the dermis;
• Ulcers are divided into a number of types: deep, follicular, superficial, but they are all distinguished by one nature – there is pus in the pustule cavity;
• Papules or nodules can be from 1 ml to 3 cm in size.Their presence changes the color and texture of the skin;
• Blisters are small formations on the skin. Their color is pink, and the life span is quite small. Very often they do not require medical intervention and disappear after a few hours;
• Spots – change the color of the skin, while the damaged dermis continues to be at the same level with the healthy one.

Causes of rashes on the palms and hands

A red rash on the palms and hands can appear for a variety of reasons.They can be quite harmless, like cold, or be a symptom of a number of serious diseases.

Allergic dermatitis

Allergic dermatitis is a dermatological disease of an allergic nature. A red rash occurs as a response of the body to an external stimulus, that is, an allergen.

It appears only if the body is initially predisposed and sensitive to this allergic reaction. The problem has a delayed effect, that is, it takes time for the reaction to proceed and the development of an allergy to the provoking factor for its full manifestation.

Allergy to cold

This allergy is one of the subspecies of urticaria, therefore it requires medical intervention and treatment.

Manifestations and causes of allergy to cold on the hands:

• Is an atypical reaction of the body to frosty weather;
• Quite often occurs with a number of complications, manifested in the form of inflammation;
• Red spots are characterized by scaling and severe itching, inflammation often cracks;
• Hands become covered with small red blisters, which makes them swollen.

Allergy to antibiotics

Antibiotics – these drugs themselves are strong allergens, the strongest reaction is the penicillin group and sulfonamides.

Manifestations of allergy to antibiotics on the hands:

• It manifests itself in the form of hives, otherwise red blisters of different sizes (sometimes reaching a size of 10 cm) and small spots;
• May be distributed throughout the body, but limbs are most commonly affected;
• After refusal of treatment, the rash should disappear in a couple of days without traces of age spots.

Allergic urticaria

Allergic urticaria is the body’s reaction to an allergen.

Signs and causes of allergic urticaria on the hands:

• The main symptom is large blisters that resemble bites or nettle burns;
• Red rash usually accompanied by unpleasant itching;
• It is very difficult to diagnose this disease, an allergist is involved;
• The provoking factor is not only cold or heat, but also a number of drugs (caffeine, aspirin), food colorings and preservatives;
• A special risk group is children under 13 years of age, when allergies are just being established.

Allergic rash on the hands of a child

An allergic rash on the hands of a child can appear at any age.

Signs and causes of allergic rash in children on the hands:

• Often as a reaction of the body to unsuitable food;
• May be chronic or hereditary;
• Caused by a malfunction of the immune system, which is highly unstable;
• In places where a red rash appears, the skin is flaky and rough;
• It is characterized by severe itching, which gives the child a lot of unpleasant sensations.

Contact dermatitis

Contact dermatitis is also called allergic because it occurs due to the constant exposure of the hands to irritants and allergens.

Manifestations and causes of contact dermatitis in our hands:

• Quite often, such a red rash appears as a symptom of other skin diseases;
• Contact with aggressive substances without the use of gloves;
• A rash appears in the form of red blistering, watery pimples, which itch violently and constantly burst, leaving wounds and cracks;
• In addition to the allergen, problems with the gastrointestinal and cardiovascular systems, infections and blood diseases can affect the appearance of contact dermatitis.

Atopic dermatitis

Ordinary dermatitis, gradually developing, in subsequent years begins to have its own nature.

Atopic rash appears due to inflammation of the skin often appears even in infants and children, and in adulthood it is not so common.

Symptoms of a problem on the hands are:

• Small red rash that has no boundaries of its own;
• Gradually merging into one large area;
• Severe itching;
• Peeling.

To cure this disease requires careful monitoring by a dermatologist and allergist with the appointment of a number of powerful hormone-based drugs and antihistamines.

Enterovirus infection

A red rash with such a disease mainly affects children under 5 years of age, in adults it is a very rare occurrence.

Manifestations of enterovirus infection on the hands:

• The infection multiplies in the gastrointestinal tract, therefore it requires complex treatment for the intestines and immunity;
• Transmitted by airborne or fecal-oral route from virus carriers or sick people;
• Appears as a red rash resembling symptoms of rubella or measles;
• Has a rash that looks like small spots or papules;
• Accompanied by fever, vomiting and headache.

Eczema

Chronic disease of a neuro-allergic nature.

Manifestations of eczema on the hands:

• Initially, a red rash appears in the form of serous itchy vesicles, which, after opening, gradually become pustules;
• The dermis of the hands gradually becomes drier, bursting vesicles are covered with cracks and crusts;
• The entire course of the disease is accompanied by constant relapses with severe itching;
• At times, eczema with a red rash is accompanied by a bacterial infection, which leads to purulent complications.

Scabies

Manifestations and causes of scabies on the hands:

• The cause of this disease and a red rash as a symptom is a scabies mite;
• Severe itching, inflammation in the form of papules and vesicles, often on the folds, can affect not only the hands, but the rest of the body;
• There are often complications in the form of abscesses, since the disease is polymorphic;
• Highly infectious;
• However, the possibility of relapse is extremely small, since during the manifestation of the disease for the first time, the body intensively produces antibodies to strengthen the immune system;
• Usually, a rash appears between the fingers or on the wrist.

Syphilis

Sexually transmitted disease, which is characterized by the defeat of skin, mucous membranes and internal organs of a person.

Manifestations of syphilis on the hands:

• One of the symptoms is the presence of red spots on the palms and hands;
• The disease is distinguished by its number of characteristic features such as edema of the genitals, weakness, itching.

If this kind of problem occurs, you should immediately consult a doctor to prevent rotting of the body.Syphilis is highly contagious, so you should completely exclude sexual activity until it is completely cured.

Gonorrhea

Gonorrhea on the hands:

• Gonorrhea rash is a rare symptom that usually occurs on the genital tract;
• Appears on the hands and between the fingers;
• On the hands it looks like papules or pustules of a small size, usually not exceeding one and a half centimeters;
• However, a red rash appears only in the acute stage, when there are a lot of bacteria and they penetrate the skin with purulent secretions;
• Typically not accompanied by itching, but only high fever and general weakness.

Intestinal yersiniosis

Manifestations and causes of intestinal yersiniosis on the hands:

• The disease is an acute intestinal infection that a person gets from an animal;
• Accompanied by a number of allergic reactions, one of which is a red rash on the back of the hand;
• Appears on the palms and hands with a generalized form of the disease;
• Runny nose, cough and fever appear together.

Psoriasis

Manifestations and causes of psoriasis on the hands:

• Not having an infectious nature, it is a disease that affects the dermis and has a chronic nature;
• On the hands, the most exposed area is the palms;
• Red rash appears as small red patches that are dry;
• They are very itchy, and due to scratching they degenerate into plaques;
• The disease does not have a fatal ending, but is considered dangerous for the psychological state of a sick person.

Vasculitis

Manifestations and causes of vasculitis on the hands:

• The disease mainly affects young people;
• A red rash with it has its own distinctive features:
  • a slight elevation above a healthy dermis;
  • fusion of several affected areas with each other;
  • almost magenta;
• Appears on hands quite rarely;
• Accompanied by swelling and pain in the stomach, vomiting and fever;
• Spots of different sizes appear at the very beginning of the disease in almost all patients, gradually becoming chronic.

Meningococcus

Meningococcal disease is an incredibly dangerous disease that in many cases turns out to be fatal or confuses a person to a wheelchair.

Manifestations and causes of meningococcus on the hands:

• Transmitted by airborne droplets;
• Not always accompanied by a characteristic rash;
• The skin becomes pale with a grayish tint;
• The rash is pale pink at first, but gradually small red patches become one large purple patch;
• Very similar to the body’s allergic reaction to a number of medications;
• Gradually the rash disappears, in their place appear hemorrhages with necrosis;
• The affected areas are the arms and legs, but in the later stages all areas of the skin.

Do not allow the appearance on the face.

Measles

Children often get measles during childhood, although many parents give their children vaccinations.

Manifestations and causes of measles on the hands:

• The disease is viral;
• The rash appears only after the onset of the acute stage of the disease;
• The rash is white and very small in size;
• After leaves small age spots that disappear after a short period of time;
• Usually resolves one week after onset;
• In adults, measles is much more severe, but the nature of the rash does not change;
• There is a sore throat.

Rubella

Another viral childhood illness. For children, it is quite harmless, except for cases of mother’s illness during pregnancy.

Manifestations of rubella on the hands:

• The rash has a pink or red tint, small size;
• First of all, it appears on the face, and then moves on to the rest of the body;
• It usually disappears 4 days after emergence;
• The spots gradually turn white, although the disease is still developing in the body.

Vaccines can be given to prevent rubella.

Chickenpox

Chickenpox can get sick at any age, but it is less dangerous for children.

Manifestations and causes of chickenpox on the hands:

• Airborne and highly contagious;
• It appears as small red spots practically all over the body;
• Within a few hours they degenerate into papules, and a day later – into vesicles with serous fluid;
• As soon as such a bubble is pierced, it falls off, and a dry crust appears in its place;
• Because of this, all stages of the rash can be observed at once on the same area of ​​the skin.

Sensitivity to colds

When the vascular permeability in the body is impaired, small and large hemorrhages appear on the skin.

However, they do not appear just like that, but are provoked by a number of other factors, in particular, the usual increase in temperature with a cold.

So this sensitivity can be attributed to diseases of the circulatory system.

Herpes

The following factors can provoke the appearance of symptoms of herpes on the hands:

• Reduced immunity, especially after operations and serious illnesses;
• Severe hypothermia of the hands;
• Injuries to fingers and hands;
• Domestic infection – the virus can be transmitted by treating a cold on the lips or in the genital area, if the bladder bursts and there are wounds or cracks on the hands;
• Avitaminosis.

Herpetic eruptions on the palms and the back of the hand are rare. But this is the most unpleasant area for the patient, because the palms are most often used in everyday life.

Ways to diagnose the source of the rash

Diagnosing the source of the rash is a rather difficult question. Such a diagnosis is made only by a dermatologist.

Diagnostics for adults:

• Visual examination – the rash is checked for characteristic features, quite often they are individual for many diseases;
• To exclude a rash as a symptom of an infectious disease, a number of tests are prescribed:
  • study of the secretion of abscesses;
  • blood test – This additional information helps to provide additional information for the diagnosis.

Differential diagnosis of rash in children:

• Initial examination of the child and palpation of the rash for characteristic features;
• Comparison of clinical examination with other research methods such as the primary element of the rash and the nature of its distribution. For example, if a rash appeared on the first day of illness, then it is a viral infection. There is a summary table of these comparisons to help the doctor determine the source of the rash.

Methods of treatment

Treatment of a red rash on the hands depends entirely on the diagnosis. If it is only a consequence of another disease, then drugs are prescribed that are intended to cure the underlying disease, and not the symptom.

For simple relief of itching and burning:

• You can simply treat the rash with brilliant green or an antiseptic to dry the bubbles, they prevent injury to the rash;
• Use a special ointment such as Skin-Cap or Panthenol.

For the treatment of scabies it is usually used:

• Sulfur ointment;
• Ice or corticosteroid ointment can be used to relieve severe itching during treatment.

For allergic dermatitis you need:

• Find out the allergen and remove it from your life;
• Nutrition, cosmetics, animals, flower plants and many other substances will need to be reviewed;
• Antihistamine ointments aimed at reducing swelling and redness, such as Fenistil and Advantan, will help for treatment.

The doctor should be involved in the diagnosis and treatment of a red rash, since the means used, the duration and course depend entirely on the cause of the onset.

Preventive measures

To prevent the appearance of a red rash, you can use the following rules:

• Constantly adhere to hygiene rules, wash your hands before eating and after visiting public places with warm water and soap;
• In the cold season, wear gloves or mittens, and in the warm season, do not expose them to direct sunlight for a long time;
• Use rubber gloves when cleaning to minimize exposure to strong chemicals;
• Normalize food by removing any allergens from it;
• Do not touch unfamiliar animals on the street;
• Each family member in the house must have their own hygiene items, you cannot use strangers;
• Use a moisturizing hand cream.

Conclusion

Most often, a red rash on the hands appears due to an allergic reaction of the body to external stimuli. Avoiding them is as simple as healing.

Another thing is if the rash is a symptom of another disease. That is why, after detecting inflammation, you need to immediately consult a doctor for a diagnosis and subsequent treatment, and not just hide your hands.

Dermatologist of the highest category and author of the dermgid website.com. For more than 15 years I have been helping people suffering from skin diseases of various origins.

Dermatoses of pregnant women

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Pregnancy is a great time for any woman, especially when it is a planned and desired event in the life of a married couple. Unfortunately, due to various circumstances, pregnancy does not always occur naturally – in such cases, modern medicine offers various procedures for assisted reproductive technologies.This makes a woman’s attitude to such a natural process for her even more reverent. And here, quite often, our skin can present surprises. A variety of skin conditions can be exacerbated during pregnancy. At the same time, traditionally prescribed drugs have limitations for use in such a situation. And here it is important that the specialist has experience in treating such situations.

Our Clinic is in some way unique, since many years of experience in managing women with skin diseases during pregnancy is not only the chief physician, who for 15 years has been a consultant at the D.O. Ott, but also other specialists who are employees of the Department of Skin Diseases of the First Medical University. Academician I.P. Pavlov.

Now let’s try to explain the causes of the occurrence and identify the most common skin diseases during pregnancy.

During pregnancy, changes in the immune system of the pregnant woman are considered to be the main cause of skin lesions. Pathological processes can be manifested by an exacerbation of chronic skin diseases or the appearance of specific dermatoses associated with pregnancy, the so-called “dermatoses of pregnant women”.

Changes in the skin are very diverse, both in manifestations and in development mechanisms. They can be conditionally divided into 3 groups:

I. Stigmas of pregnancy:

Chloasma is the most famous of them. As a development mechanism, various functional endocrine-metabolic changes during pregnancy are assumed. It manifests itself as brownish spots of indeterminate outlines, often symmetrical, on the skin of the cheeks, forehead, chin, neck without subjective sensations.Chloasma can occur at different times of gestation, intensifying as it develops and disappearing without a trace soon after childbirth. But with subsequent pregnancies, chloasma reappears. Exposure to sunlight increases the appearance of spots.

Melanosis of pregnant women – changes in the skin in the form of hyperpigmentation in the nipples, genitals, white line of the abdomen, also without subjective sensations or inflammation. After childbirth, these disorders disappear. Chloasma and melanosis usually do not require special treatment and regress spontaneously after childbirth.

II. Skin diseases reported relatively frequently during pregnancy:

This group includes a variety of skin changes and diseases that often accompany pregnancy, as well as some common dermatoses, which are usually aggravated during gestation. The main mechanism is a change in hormonal ratios in the body of a pregnant woman. This, in turn, affects the functional capabilities of the immune and nervous systems, the state of the gastrointestinal tract, kidneys, cardiovascular activity, water-salt metabolism, etc.

This group includes: hyperhidrosis

• hypertrichosis
• palmar-plantar telangiectasia
• erythema of palms
• alopecia – hair loss
• onychodystrophy – changes in the nail plate

Most of these and other conditions usually disappear after childbirth. Their treatment, if necessary, is symptomatic.

The course and severity of symptoms of other skin diseases also changes during pregnancy. These primarily include eczema, atopic dermatitis, psoriasis, lichen planus, acne, Dühring’s dermatitis herpetiformis. During pregnancy, they are often exacerbated, and exacerbations are usually more pronounced and more severe than before gestation. Sometimes, on the contrary, during pregnancy, remission occurs, which continues until childbirth, after which another exacerbation occurs. Correction of exacerbations of these dermatoses during pregnancy is very difficult. Many medicines used under normal conditions affect the development of the fetus.Therefore, external symptomatic therapy becomes the leading method.

III. Actually dermatoses of pregnant women

Four skin diseases characteristic of pregnancy, pemphigoid of pregnant women, polymorphic dermatosis of pregnant women, atopic dermatitis of pregnant women, and cholestasis of pregnant women can be distinguished by clinical presentation, histopathology, risk of complications in the fetus. Only pemphigoid in pregnant women and intrahepatic cholestasis in pregnant women are associated with a significant risk to the fetus.Since all of these dermatoses are pruritic, a careful assessment of any pruritic pregnancy is necessary.

Pregnant pemphigoid , formerly known as pregnancy herpes, is the rarest skin disorder in pregnancy and is an autoimmune disease. Clinically manifests itself in the form of papules and plaques, transforming into vesiculobullous elements, localized in the navel with spread to the chest, back and limbs.Pemphigoid usually resolves spontaneously within a few months after delivery. As a rule, there is a relapse of dermatosis during subsequent pregnancies with an earlier onset of dermatosis and greater severity compared to the previous pregnancy. Treatment should be aimed at reducing itching and blistering. In mild cases, topical corticosteroids and antihistamines are effective. In severe pemphigoid, it is advisable to use systemic corticosteroids.

Polymorphic dermatosis of pregnancy (PEP) is a benign, itchy inflammatory disease.It usually occurs in the late third trimester or immediately after delivery in the first pregnancy. Urticarial papules and plaques appear first on the abdomen and, unlike the pemphigoid of pregnant women, do not affect the navel. The rash usually spreads to the thighs and buttocks, and can rarely be widespread. Well-defined rashes will regress spontaneously within 4-6 weeks without treatment. Treatment for PEP is based on symptom relief using topical corticosteroids and antihistamines.If the rash becomes generalized, a short course of systemic corticosteroids may be used.

Atopic dermatitis of pregnancy (AEP) is the most common skin disease in pregnant women. AEP is a benign disease characterized by an itchy eczematous or papular rash. Two-thirds of AEP cases are characterized by eczematous skin changes localized to atopic areas of the body, such as the neck and flexion surfaces of the extremities.The rest of the cases are characterized by a papular rash in the abdomen and extremities. Lesions usually respond well to treatment and resolve spontaneously after delivery. However, AEP is more likely to recur in subsequent pregnancies. Dermatosis does not significantly affect the fetus, but there is an increased risk of developing atopic dermatitis in an infant.

Intrahepatic cholestasis of pregnancy (ICP) – characterized by acute onset pruritus that often begins on the palms and soles and then generalizes.There are mainly secondary lesions on the skin, such as excoriation, but there may be papules. In 10%, jaundice develops due to concomitant extrahepatic cholestasis. After giving birth, the itching goes away within a few weeks. There is a risk of relapse in subsequent pregnancies. Diagnosis of ICP is important because there is a risk of complications for both the mother and the fetus.

Treatment is aimed at normalizing serum bile acid levels to reduce the risk to the fetus and control symptoms in the mother.Treatment with ursodeoxycholic acid (UDCA) is recommended. Other drugs that relieve itching may be used, such as antihistamines, dexamethasone. Treatment of pregnant women with dermatoses is very difficult, especially in the first trimester of pregnancy. If dermatosis is detected in a pregnant woman, it is necessary to jointly manage it by a dermatologist, obstetrician-gynecologist. Treatment of dermatoses in pregnant women requires a differentiated approach to therapy, taking into account the duration of pregnancy, exacerbation of the disease and the prevalence of the process.

The clinic has sufficient laboratory facilities and all the necessary equipment for the diagnosis and treatment of conditions such as dermatoses of pregnant women.

Why palms itch and what to do about it

When you need to urgently seek help

In some cases, itching of the palms can be a symptom of deadly conditions ^.

Call an ambulance immediately if, in addition to your itchy hands, you notice:

• Difficulty breathing.This combination may indicate a serious allergic reaction – developing anaphylactic shock.
• A yellow tint to the skin or whites of the eyes. This indicates an obvious malfunction in the liver.

An ambulance may not be called, but it is advisable to visit a therapist as soon as possible if, in addition to regular itching, there are:

• Seemingly unreasonable weight loss. This combination of symptoms can accompany certain cancers – especially Hodgkin’s disease.
• Prolonged enlargement of lymph nodes for several weeks or more. Here the reason may be the same as in the paragraph above.
• Too infrequent need to urinate – less than ^{four times a day. This combination is a possible sign of developing kidney failure.}

However, these situations are still rare. More often than not, itching is caused by relatively harmless things.

Why palms itch

Researchers identify ^{five common reasons.}

1. Dryness and irritation of the skin

This is especially true during the winter season, when the humidity in the premises drops. The skin rapidly loses moisture, and the thin epidermis on the palms suffers first of all. This is how irritation, peeling and itching appear.

Dry skin also occurs for other reasons – for example, due to a decreased activity of the thyroid gland (hypothyroidism).

Or maybe you just used the wrong soap or detergent? Or rubbed your palms too thoroughly while washing your hands? A thin film of sebum on the surface of the epidermis could be destroyed, and this caused irritation and itching.

2. Allergic reaction

An object or plant that you touched could have caused an allergy. Or, for example, a hand lotion containing an irritant substance to which your skin has reacted. Another option: the reaction was caused by the use of a product or medicine.

An important nuance: allergic itching does not always start immediately. Sometimes it takes several hours between the impact of the stimulus and the realization “oh, my palms are itching”.

3. Atopic dermatitis

It is also eczema. By the way, a fairly common condition: in the United States, 90,830 about 10% of people suffer from atopic dermatitis affecting the hands.

This non-communicable disease can cause redness, color (pink, grayish, brownish) spots, blisters and itching on the palms.

Most often people suffer from eczema ^{, whose hands are regularly exposed to moisture and aggressive chemicals:}

• hairdressers;
• cleaners;
• catering employees;
• mechanics;
• Medical laboratory and hospital workers.

Eczema can either disappear for several months or worsen again, sometimes for no apparent reason.

4. Hyperglycemia or diabetes

Elevated blood sugar can also be felt with itchy palms.

5. Damage to nerves

Diabetes can also damage nerve fibers in the palms. Or a disease called tunnel syndrome (aka carpal tunnel syndrome), which is popular among those who spend a lot of time at the computer with a mouse in their hands.

Such disorders often cause discomfort, numbness in the hands and at the same time itching in the palms.

What to do if palms itch

If this is a one-time action or itching rarely appears (once a month, once a year), you do not need to worry. But if the palms itch with enviable constancy, it is worth looking into the reasons.

Consult a physician or dermatologist. The doctor will examine you, ask you about your lifestyle, diet, clarify if you are taking certain medications and, possibly, send you for a blood test or skin scraping.Treatment is prescribed based on test results.

In case of an established allergy, you will be prompted to calculate the allergen product and minimize contact with it. Your doctor may also recommend taking antihistamines.

For eczema, you will be prescribed medicated lotions or steroid ointments.

If the cause of itching is hyperglycemia, diabetes, carpal tunnel syndrome, first you need to cure or correct the underlying disease. After that, your hands will stop itching by themselves.

How to relieve itchy palms at home

Before you get to the doctor, you can try to reduce the discomfort yourself.

1. Apply cold compresses

For example, apply gauze wipes soaked in cool water to your palms for 5-10 minutes. Or, grasp a bag of frozen vegetables wrapped in a thin cloth.

2. Stay hydrated

Try to drink at least 2.5 liters of fluid a day. We remind you: tea, juices, liquid soups, juicy fruits are also considered.

3. Keep an eye on the air humidity in the room

The optimum humidity level is ^{– 40-60%.}

4. Moisturize your hands regularly

Moisturizing creams and lotions can help. Naturally, those to whose ingredients you are not allergic. If in doubt, ask a therapist or dermatologist to help you find a hypoallergenic product.

5. Protect your hands from exposure to chemicals

Wash dishes, wet clean, dye your hair only with rubber gloves.

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Palm allergies: causes, symptoms, treatment, prevention

An allergic reaction on the palms of the hands, as a rule, occurs as a result of exposure to external and internal stimuli. Hands are the most vulnerable part of the body, which comes into contact with a huge number of objects during the day. Therefore, the appearance on the surface of the palms of negative manifestations is understandable.

The development of an allergic reaction can be acute and protracted (chronic).

• The chronic process is characterized by lichenification, when the skin coarsens, thickens, and quite often the rash begins to peel off. In some cases, atrophic changes in the skin are noted with the appearance of deep cracks.
• The acute course of allergy on the palms is expressed by hyperemia of the skin, edema. Often, watery blisters with transparent or bloody contents appear on the palms.Bubbles can burst under external influence. This condition gives a person discomfort, it is especially difficult to endure such a condition for a small child. As the healing progresses, areas with keratinized skin are possible.

If timely treatment of an acute form of allergy is not carried out, then it can develop into a chronic form. With the development of dermatitis, dryness and burning of the skin may join the usual allergic symptoms, manifested by redness and itching.

Reasons

Allergic reaction on the hands of an adult and a child most often due to the following reasons:

• A rash on the palms of the hands may result from close contact of the skin on the hands with household chemicals.These include washing powder, fabric softener, dish detergent, etc. As a result of exposure to an alkaline environment, the skin is significantly damaged.

• The causes of the disease may lie in unfavorable climatic conditions, when the skin is damaged by exposure to high or low air temperatures. Therefore, in the cold season, the appearance of allergies on the palms, especially in a child, is observed quite often.
• The influence of food allergens is of great importance for the development of the disease.Therefore, it is necessary to exclude from the diet all provocative foods and low-quality food. In children, the causes of allergies may be related to the immaturity of the digestive system.
• Synthetic fabric may be the cause of your allergy. Especially often, allergic rashes on the palms are noted in a child when he touches such material, as well as low-quality toys.

Symptoms

The most common allergic manifestations are accompanied by the following symptoms:

• fine blistering rash on the palms of the hands;
• severe burning and unbearable itching;
• an increase in body temperature is sometimes noted;
• with complications, cracks may occur in the fold line of the palm.

Allergic manifestations may be mild or obvious. The treatment of the disease depends on the severity of the symptoms.

Treatment

First of all, it is necessary to perform a diagnostic examination, identifying the reasons that provoked an acute allergic reaction. After determining the allergen, a course of treatment is prescribed, which is aimed at relieving allergic symptoms and preventing possible relapses.

• In the event that the causes of negative manifestations arise from food, the doctor prescribes a hypoallergenic diet.In addition, with the development of a pronounced reaction, infusion therapy is recommended to remove toxic substances from the blood;
• for the relief of allergic manifestations, a number of prolonged-acting antihistamines are primarily prescribed. Recently, the most common treatment has been using third-generation drugs: Loratadin, Fenistil, etc. These drugs have a minimal number of side effects and do not have a sedative effect on the nervous system.This is especially important when treating a child;

• for severe development of an allergic reaction, treatment involves the use of hormonal drugs orally and as external use. Typically, the ointment is applied directly to the palm itself in a very thin layer. The most effective use of such external drugs as Gistan, Fenistil-gel, Desitin. These drugs effectively relieve skin manifestations in the form of inflammation, redness, itching and are allowed for use even for a child;
• in especially difficult cases, the allergic process may be accompanied by a suppurative process as a result of the ingress of pathogenic microflora into the wound surface.In this case, antibiotic therapy is recommended while blocking the inflammatory process. To do this, you can use ichthyol and Vishnevsky ointment.

It is important to remember that self-treatment of allergies on the surface of the hands is strictly prohibited. All therapeutic measures are performed only after the appointment of the attending physician. This is primarily due to the individual sensitivity of the organism and it is likely that medicines for an adult patient are not suitable for treating a child.Therefore, the dosage and choice of antihistamines depends on the age of the patient and the state of the immune system.

Prevention

The causes of allergies depend on many factors, but it is better to prevent the disease in a timely manner than to spend energy and money on expensive treatment.

For this, care should be taken when eating food, especially for people with a hereditary predisposition to allergies. For this category of patients, a special diet is being developed with the necessary vitamins and minerals, while completely eliminating the allergen itself.

It is important to use hypoallergenic cosmetics and household chemicals. If contact with detergent cannot be avoided, protect the palms of the hands with rubber gloves. In the cold season, be sure to keep your hands warm.

Allergic manifestations on the palms

In the absence of external irritations and disorders in the functioning of internal organs and systems, the skin has a healthy appearance. As soon as pathological failures occur, phenomena that occur on the skin will become evidence of them.It is about this nature of peeling, itching, red rash that can be asserted with great confidence.

A red rash, which is localized on the palms and hands, can differ not only because of the formation, but also in appearance:

1. Vesicles, which are cavities with serous-type fluid contained inside. Usually their sizes do not exceed 10 mm, they can be one-dimensional and multidimensional. An autopsy leads to the formation of ulcers and erosions.
2. Ulcers, in the cavity of which there is a purulent fluid.Formations can be deep, follicular, superficial.
3. Papules with nodes 10-30 mm, due to the presence of which the color of the skin, their consistency may change.
4. Blisters are small skin lesions. They have a pink tint and disappear relatively quickly. In some cases, medical attention is not required.
5. Spots – contribute to skin changes, but at the same time do not differ in level from other intact areas.

If a rash on the palms is observed with a simultaneous increase in temperature, sore throat, sensations of aches and other symptoms, then you should consult a doctor.This is especially true for young patients.

1. Cold allergy, which is a typical reaction to low temperatures. It is often accompanied by a variety of inflammatory changes. The spots cover not only the palms, but also the upper surface of the brushes. They peel off, itch and crack. Due to the appearance of small blisters, swelling is visualized.
2. People often experience skin reactions to antibiotics such as the penicillin group, sulfonamides.Usually hives cover the hands, red blisters or simple spots may form. Spread to the body is allowed, but usually the reaction is limited to the limbs. Termination of therapy leads to the disappearance of the phenomena and the normalization of the skin condition.
3. Allergic urticaria is a large, bite-like blister that is not limited to the hands but occurs over the entire surface of the limbs. Severe itching is felt. It can be caused by temperature changes, the influence of medicines, food-type dyes, preservatives.It is often observed in children under 13 years of age.
4. Rash in children. An allergy manifests itself on the palms, hands and arms of the baby. Food acts as a provocateur, is distinguished by a chronic course or heredity. Often occurs against a background of weak immunity. At the site of the appearance of the red rash, peeling and coarsening of the skin is observed, itching is felt.

Dermatitis

Contact dermatitis is usually of an allergic nature, as it occurs due to exposure to irritants directly on the hands.A red rash indicates skin ailments or careless handling of an aggressive environment. There are bubbles, water pimples, after the rupture of which traces remain. The patient feels itching. Pathologies of the heart, gastrointestinal tract, and blood diseases are capable of provoking an ailment.

Atopic dermatitis is mainly inherent in children. A small, red rash appears that has no borders. Itching and flaking is observed.

Psoriasis and eczema

Psoriasis lacks an infectious nature, this ailment affects the dermis layer and is chronic.The red rash is most pronounced in the area of ​​the palms – small dry spots appear. In addition to itching, psoriasis on the palms is unpleasant and another phenomenon – as a result of scratching, they become plaques. Usually, such an ailment exerts negative psychological pressure on the patient.

Eczema on the palms has a chronic course, it is based on neuro-allergic factors. The rash is red, takes the form of serous-type vesicles. They itch a lot, and after opening they transform into abscesses.As the disease progresses, the skin becomes drier, and cracks with crusts appear in the place of the bursting bubbles. After some weakening of the symptoms, the disease again manifests itself with a relapse. If an infection of a bacterial nature joins the eczema, then a purulent complication begins.

Scabies

The disease is caused by the action of a scabies mite, under the influence of which a red rash is visualized, accompanied by severe itching, inflammatory formations in the form of papules with vesicles.They usually appear on the folds of the arm, fingers, and extend beyond the upper limbs. The polymorphism of the disease allows the formation of abscesses. Scabies is contagious, so the appearance of symptoms between the fingers and on the wrist should alert the patient. As the person progresses, they develop immunity.

Infectious diseases

Among this group of diseases, there are those to which we are already accustomed, for example, chickenpox or scarlet fever, but there are also new ones, in particular, enterovirus infections, the Coxsackie virus.For some of them, it is possible to vaccinate.

The following types of infections are distinguished, accompanied by rashes on the palms and hands:

1. Chickenpox is a contagious disease transmitted by airborne droplets. The bubbles begin to localize in the head area, and then spread to the entire body, palms and feet. Red spots turn into papules after a few hours, and within a day – into vesicles filled with serous fluid. After opening, a dry crust forms.With a mild course, a slight increase in temperature is possible, in more severe situations, fever, chills, nausea with vomiting appear.
2. Rubella appears as a small red or pink rash on the palms of the hands after it has appeared on the face. Gradually, the rash spreads over the body, and after 4-5 days they disappear. In this case, the spots first begin to turn white, although the disease is still active.
3. Measles – a disease of a viral nature, first develops as an acute respiratory viral infection, and then manifests itself in the form of conjunctivitis and the appearance of large red spots.They gradually start to merge. There is soreness in the throat. Within a week, the disease goes away. Adults are more difficult to tolerate exposure to the virus.
4. Scarlet fever, which is accompanied by a small rash. It arises on the neck and face, and only then passes down the body. The usual one is preceded by streptococcal angina. Weakness and nausea are observed.
5. Meningitis is the result of a meningococcal infection. This is a dangerous ailment with serious complications. Vascular paralysis leads to local skin hemorrhages.Against the background of the rash, the temperature rises, there is a pain in the head. The rash is at first pale pink, then a crimson spot forms, which is replaced by hemorrhage with necrosis. The limbs are exposed to rashes in the first place.
6. Enteroviruses – they affect children under 5 years of age. A red rash affects the palms and feet and resembles the development of measles or rubella. Redness of the palms occurs due to the appearance of spots and papules. There is a fever, headache, nausea. Among such infections, the Coxsackie virus has recently become famous.
7. Intestinal yersiniosis – the source of infection is animals. Manifested by allergic phenomena, including a red rash on the back of the palms. It is accompanied by a runny nose, cough, fever.

Erythrosis

Lana’s disease is accompanied by a rash on the palms in the form of red spots. In this case, sweating will be absent. This is the so-called palmar and plantar erythema of a hereditary nature. The rash will also be present in the area of ​​the feet.

Hypovitaminosis

This condition is often evidenced by the manifestation of hyperemia of the palms. They turn scarlet, fingers and hands go numb. If there is an itching with burning sensation, then you should check for a deficiency of vitamins of group B. The reason for the development is an unbalanced diet – a deficiency of useful components impairs the functioning of the heart, blood vessels, the central nervous system, and undermines the immune defense.

Disorders in the liver

Adults often complain of prolonged redness in the area of ​​the palms.In this case, itching is present, but other symptoms are not observed, the patient’s condition is normal, there is no malaise. In such a situation, it is advisable to check the functionality of the liver. Abuse of junk food, alcohol, frequent infectious ailments lead to regular intoxication of the body. The liver cannot cope with this effect. The appearance of red spots on two palms can be a sign of liver cirrhosis, hepatitis.

Defeat of parasitic nature

Rash on the skin, including on the surface of the palms, in children can become a symptom of the development of helminths inside the body.These parasites produce toxins that trigger a response from the immune system. The production of protective cells begins, and the epidermis is covered with an allergic rash.

Hives on the palms in this case will not only be accompanied by itching and inflammation of the adjacent tissues, but also other symptoms:

• bowel dysfunction;
• darkening of the skin under the eyes;
• progression of anemia;
• Itching sensation in the anus.

Do not forget that babies’ skin is very sensitive. Therefore, bacteria of the fungal type easily settle on it and multiply. As a result, active eruptions appear on the palms and feet, transforming into erosion with peeling.

Sexually transmitted infections

There are venereal ailments that are widespread among the adult population. Diseases are contagious, and therefore during treatment, sexual intercourse should be limited.

Syphilis

The disease affects the skin, mucous membranes and internal organs of a person. Red spots are actively spreading along the palms and hands, there is swelling in the genital area, itching appears, the patient complains of constant weakness. The onset of symptoms requires prompt treatment in honey. institution. Timely diagnosis will help initiate therapy, which, however, will be quite lengthy.

Gonorrhea

With this ailment, the rash occurs infrequently and mainly affects the genital area.In rare cases, rashes appear in the area of ​​the hands and in the spaces between the phalanges of the fingers. If formations appear on the hands, then the papules are small in size within 15 mm.

This symptom is present in the acute phase of the development of the disease. It is during this period that a large number of bacteria penetrate the skin layers, which is accompanied by discharge in the form of pus. There is no itching, the temperature rises, the patient complains of weakness.

Diagnostic features

To determine the cause of the disease and symptomatic manifestations, a comprehensive examination is necessary.Often the source is not a dermatological nature, but infectious factors.

In the process of diagnosing the disease in adults, the following activities are carried out:

1. Examination of the patient visually, determination of the characteristic features of the rash, which can tell about the causes of the appearance.
2. To exclude an infectious nature, tests are carried out to identify pathogens.
3. Blood test to characterize the general condition of the patient and clarify the diagnosis.
4. Carrying out an allergy test for suspected allergic dermatitis on the palms.

Children are more susceptible to infectious diseases, such as chickenpox, measles and rubella. Therefore, in the process of differential diagnosis, the baby is examined primarily, the doctor must feel the rash in order to determine its characteristic features. Clinical examination is complemented by other research methods. The peculiarity of the appearance of the rash, the nature and frequency of its distribution is taken into account.

Peculiarities of treatment

Therapy for red rashes on the palms is determined by the diagnosis. If the appearance of a rash is determined by the development of other diseases, then drug therapy is focused on getting rid of the underlying ailment, and not signs.

In some cases, no special treatment is required, and the therapeutic effect will be aimed at alleviating the patient’s condition and eliminating itching with burning. In this case, antihistamines may be prescribed, special topical ointments (for example, Skin-Cap or Panthenol) may be prescribed.To exclude injury to the rash, it is advisable to dry them with an antiseptic.

Sulfur ointment is prescribed for the treatment of scabies and the rash it causes. Itching and burning can be eliminated with corticosteroid ointments or conventional ice compresses.

Dermatitis of an allergic nature requires the primary elimination of the effect of the irritating factor. At the same time, it is advisable to consider the possibility of adjusting the nutritional plan, used cosmetics, detergents.

In some cases, it will be necessary to limit contact with plants and animals. Topical antihistamines can help relieve swelling and redness. Doctors recommend using Fenistil or Advantan. If the cause is a bacterial infection, then antibiotics are indispensable.

Features of the treatment of babies are as follows:

1. In the absence of pronounced symptoms of a different nature, the inflamed areas are treated with anti-itching agents, for example, Advantan or Lokoid.
2. For newborns, it is advisable to do baths with a decoction of a string or chamomile.
3. Allergic dermatitis requires antihistamine therapy with Suprastin, Tavegil or Erius at an appropriate dosage. In this case, it is required to exclude contact with the allergen.
4. A rash caused by bacteria is treated with antibiotics prescribed by a healthcare professional.
5. When spots appear on the palms and feet, which is accompanied by a rise in temperature to critical values, vomiting, problems with consciousness, difficulty breathing, swelling, skin hemorrhages in the form of asterisks, you should immediately call an ambulance.

Preventive measures

To minimize the risks of a red rash on the palms and hands, it is advisable to adhere to simple rules:

1. Observe good hygiene, wash hands with soap and water before eating and after visiting public areas.
2. Wear gloves during cold weather. In the hot season, it is advisable to limit prolonged contact with the sun’s rays.
3. When cleaning with household chemicals, use rubber gloves.
4. In case of sensitivity to certain allergens, exclude contact with them.
5. Do not touch street animals.
6. Use only your own personal hygiene items.
7. Apply protective moisturizing creams.
8. Carry out regular wet cleaning in the apartment.
9. Spend more time outdoors, taking precautions against pollen allergies.
10. To improve immunity, take mineral and vitamin complexes.
11. Adhere to a vaccination plan, especially for children.

Allergy on the palms of a child: causes and treatment

Hello dear readers. Today we are talking about what causes allergy on the palms of children, how it manifests itself, what methods are used to diagnose the allergen and to treat the disease.

Allergy on the palms of children occurs due to the ingestion of an allergen in the child’s body. Many substances can be the irritants that trigger the allergic process.

The child’s immune system, which has not yet fully formed, perceives the allergen as a harmful agent and begins to fight it, throwing histamine into the bloodstream.

In this case, the child develops an allergy, a symptom of which may be skin lesions on the palms. If the parents notice such manifestations, the child should be examined by a specialist.

He will determine which irritant causes an allergic reaction and prescribe adequate therapy. Self-medication is unacceptable, since it is fraught with the development of the disease to severe forms.

1. Causes of allergic rashes on the palms
2. How allergies manifest in the palms
3. How a specialist diagnoses and treats a disease
4. Preventive measures
5. Important to remember

Causes of allergic rashes on the palms

The response of the child’s immune system in the form of a release of histamine can be provoked by the following stimuli:

• Food products. The child may react to one product or several.Doctors divide products according to the degree of allergenicity. The highest degree is possessed by vegetables and fruits of red or orange color, cow’s milk, eggs, nuts, seafood, chocolate. In addition, cross-allergy is possible when, with intolerance to one of the products, intolerance to others begins. Allergenic foods can cause allergies on the palms and feet of the child.
• Hair of pets (the hair of animals usually contains their saliva, it contains a protein, which acts as an allergen for the child).
• Household chemicals.
• Insect bites.
• Cold air. An allergic reaction to cold, which can manifest itself as a rash on children’s palms, as well as feet, is now being diagnosed more and more often.
• Household dust.

How does palm allergy manifest?

Allergy on the palms of children develops in the same way as other skin lesions with allergies. If, when an allergen enters the body, an allergy appears on the palms of a child, it may be accompanied by certain symptoms:

• Rash on the palms; the skin of the palms is very itchy and burning.Small bubbles may form and coalesce into larger formations. If you do not start treatment, the rash on the palms becomes one large lesion, crusts form, and a crack may appear in the palm.
• Swelling of the skin on the palms, hyperemia.
• Blisters that look like burns.
• Temperature rise.

Cases when allergic manifestations occur only on the palms are now often diagnosed. Signs of allergy on the palms of children can be violent, or they can be minor.

They usually appear soon after contact with an allergen. Even with minor symptoms, a specialist consultation is necessary. If allergies on the palms are not treated, the disease will become chronic.

How a specialist diagnoses and treats a disease

After examining the child, the doctor will definitely prescribe laboratory tests that will help determine exactly which substance triggered the allergic process. A blood test for immunoglobulin E will make it possible to identify an irritant.Also, the allergen is diagnosed using skin tests, but they are carried out only for children from 7 years old.

The first therapeutic measure is to avoid contact with the identified allergen. In addition, medication is prescribed to remove the symptoms of the disease.

In many cases, when an allergy occurs on the palms of children, it is sufficient to exclude the irritant from the child’s life. For example, if it is a food allergy (more on it in the article), the product that caused the allergic reaction is excluded from the children’s menu.

The specialist will also describe in detail a hypoallergenic diet. If the child reacts to pet hair, it is necessary to make sure that the child cannot come into contact with the animal.

If signs of allergy appear in connection with the use of certain cosmetics and detergents, they must be discarded.

The therapeutic course for drug treatment usually includes:

• Taking antihistamines that block the release of histamine, extinguish an allergic reaction, and remove allergy symptoms on the palms of children.Children are recommended to use drugs of the latest generation, which do not have a negative effect on the central nervous system and do not cause side effects. Zyrtec can be used by children even from one month of age. In combination with antihistamines, the doctor may also prescribe enerosorbents that bind and remove toxins from the child’s body. Enterosgel and Polysorb are good help in this case.
• The use of local remedies (creams, ointments, gels) that will heal sore skin on the palms.Fenistil-gel is used very often if a child’s allergic rashes are localized on the skin of the palms. Bepanten ointment is also often prescribed.
• Using traditional medicine methods. To combat skin lesions of the palms, decoctions of birch buds, grape leaves, oak bark are well suited. Broths are used in the form of lotions and compresses.

All medicines (and traditional medicines too) are prescribed exclusively by a specialist.

The doctor always tries to do without hormonal antihistamines and external agents.But there are such severe forms of allergies on the palms that no cure is possible without such drugs.

But they are prescribed for a very short time in order to relieve pronounced symptoms, and then the treatment continues with the help of non-hormonal drugs.

The exclusion of contact with the allergen should be constant, and drug treatment is prescribed only when allergic manifestations appear.

If parents follow all the recommendations of a specialist, relapses of allergies on the palms of a child can be avoided.

Preventive measures

If a child has a tendency to allergic reactions, it is necessary to adhere to the rules of prevention in order to avoid allergies on the palms. Preventive measures include:

• Compliance with a hypoallergenic diet.
• Refusal from cosmetics, hygiene products containing many additives, fragrances.
• Testing of any new cosmetic or detergent (the product is applied to the bend of the child’s elbow, the parents monitor the reaction; the test is repeated a day later).
• In winter, the child should wear mittens (synthetics are excluded, and woolen mittens are excluded in case of allergy to wool). Before a walk, a protective cream should be applied to the child’s arms.

Important to remember

1. Sometimes allergic manifestations are localized in a child only on the skin of the palms.
2. The causes of palm allergies can be caused by various irritants.
3. If even faint signs of allergy appear on the palms of the child, it is necessary to take him to a doctor to determine the allergen and prescribe qualified treatment.

See you in the next article!

Allergy on the palms and hands: photos, causes, treatment in children and adults

Allergy to the hands and palms of the hands is one of the many manifestations of an allergic disease. In more frequent cases, it occurs independently, is localized on the hands and has nothing to do with other diseases. It is only in rare cases that an association with other skin reactions throughout the body or systemic diseases can be noted.

General information about the disease

A rash on the palms is a fairly common disease of allergic etiology that can occur in everyone, regardless of age.

The most important factor in getting rid of this disease is to eliminate the root cause of its occurrence. But, unfortunately, there can be many reasons. First of all, you need to figure out what it is.

An allergic reaction is an inadequate response of the immune system to any molecule of protein or non-protein nature, which does not cause such a reaction in the body of a healthy person.

The sensitized organism reacts inadequately to contact with the allergen, throwing out a large amount of biologically active substances at the contact point. The pathogenesis of allergy involves substances such as: histamine, bradykinin, heparin, leukotrienes and prostaglandins.

After the initial contact and the release of cytokines, vasodilation (expansion) of the vessels occurs, the release of fluid from the bloodstream into the tissue. In turn, the discarded biologically active substances destroy cells that have been in contact with the allergen.

After some time, immune blood cells – leukocytes – migrate to the inflammation zone. It is their appearance at the site of the lesion that begins the stage of convalescence – the creation of connective tissue in the place of dead cells and the restoration of defects.

Pseudo-allergies are separated into a special group. They occur in a healthy person upon contact with a very large amount of any substance, even if the body is not sensitized.

Allergic reactions have a genetic tendency, which means that if a child’s parents are allergic, then he has a much higher chance of becoming allergic as well than a child without such a pathology in the family.People often get allergic disease during childhood.

Allergies to the palms of a child or adult are often directly related to more serious diseases such as atopic dermatitis and bronchial asthma.

Reasons for the appearance of

Inflammation does not exist without contact with a provoking substance. If all suspicions of the existence of an allergen are excluded, you need to think about another cause of the disease, because many diseases can cause a similar clinical picture.

To start such local inflammation, contact with the allergen must be carried out on the hands themselves. Here is an example of the most common causes of peeling palms and other hand allergies:

• Household chemicals. Anything, even the most expensive and hypoallergenic chemicals, can cause a reaction. Most often, these are detergents for dishes, furniture or a bathroom.
• Hygiene products. As is the case with household chemicals, even the Soviet soap, tested over the years, unfortunately, can be the reason.All shampoos, liquid soaps, shower gels and cosmetics that come into contact with the hands.
• Industrial chemicals and labor hazard. Even with the most advanced protective equipment, there is no way to avoid contact when handling hazardous substances.
• Parasites. All parasitic creatures and their waste products are triggers for our immune system. In one case, the usual scab on either side of the palm may be the cause. There may also be a manifestation of another parasitic invasion hidden under the usual allergy – helminths in the intestines, liver or other organs.
• Contact with fungi and their metabolic products.
• Contact with certain types of bacterial pathogens and the simplest.
• Food products. This refers not only to contact with food directly when preparing food, but also the consequences of contact with an allergen when eating.
• Cold allergy. The pathogenesis of this nosology differs from the classical one, because the role of the trigger is played by our own altered protein called cryoglobulin. People with this form of allergy are not susceptible to changes in temperature or a strong drop in temperature.Logically, exacerbations are more often observed in the winter period of the year.
• In more rare cases, red patches on the palms and other signs are not an independent disease, but a symptom of a more extensive disease. An example is atopic dermatitis.

Varieties and variants

As mentioned earlier, true allergies and pseudo-allergies can be distinguished. The difference between them is in the amount of trigger substrate.

So, in the true form, the palms of people peel off upon contact even with an amount of the pathogen invisible to our eyes, when, in case of pseudo-allergy, an interaction with a huge amount of substance should occur.

Thermal intolerance is distinguished as a separate form – cold or heat allergy, in the pathogenesis of which cryoglobulins play an important role. A distinctive feature of this form is that it is almost impossible to get rid of it.

While the classic variant may regress when contact with the allergen is withdrawn and medications are taken, this variant is not amenable to drug therapy. You can only reduce the number of episodes of occurrence – avoid strong temperature changes, use warm mittens, and so on.

Classic clinical picture

Most allergy sufferers get used to having pimples on their palms, itchy pain, redness and swelling. It is worth figuring out which signs are the classic clinical picture of dermatitis.

Redness of the palms is the first sign after contact with an allergen. At first, the skin acquires a light red hue, which becomes more intense over time.

Almost in parallel with redness (hyperemia), swelling of soft tissues also occurs.More clearly, this symptom manifests itself on the dorsum of the hand, which is due to the anatomical features of the outflow of blood. Swelling begins at the site of the greatest amount of loose connective tissue and gradually spreads to other areas.

Allergy on the palms of the hands is also manifested by a more unpleasant symptom – itching. The intensity varies from insignificant to the strongest, at which the patient takes it for pain. Often accompanied by scratching of the itching site, from which damage to the epithelium occurs, defects (red dots, bubbles) and blisters on the palms occur.

Such an outcome of events leads to the emergence of the likelihood of secondary bacterial infection, because the damaged skin begins to peel off, itch and cannot perform its protective function.

In most cases, patients also complain that they have pimples on the palms. A rash often occurs after all of the above signs on the inside or outside of the palm, and is a reliable sign of allergy. Tends to merge, the formation of conglomerates.After the spots disappear, subtle zones of hyperkeratosis remain on the skin, which disappear over time.

Children may also experience an allergic reaction on their palms. Its feature is a fuzzy clinical picture, which may include only a few of the described symptoms.

Similar symptoms can occur on the feet. The skin of the feet is often exposed to fungal toxins, dirt, and other chemicals.

Treatment directed at the root cause

The initial intervention should be directed to the elimination of the allergen.In unclear cases, to find out the cause, additional research can be carried out in the form of specific allergy tests, prick tests, and so on.

A blood test can also help with this, with the help of which you can exclude some of the causes and confirm the presence of the allergic reaction itself.

Only after determining the root cause and eliminating its influence, it is worth moving on to drug symptomatic therapy.

A pathogenetically justified method is the use of a group of drugs that reduce the effect of biologically active substances on tissues.The group of H1-histamine blockers is ideal for this.

Treatment with histamine blockers can also be carried out at home. Depending on the side effects, several groups of these drugs are distinguished, from which their price also changes. Antihistamines come in many forms and are suitable for both oral and topical use.

You can use older generations: Clemastin, Prometazol, Diphenhydramine, Suprastin. But it should be borne in mind that the 1st generation antihistamines have sedative side effects.Not recommended for drivers or people with responsible work – crane operators, dispatchers, and so on.

Another generation of drugs, more purified, does not have a hypnotic effect. It includes: Ebastine, Loratadine, Cetirizine, Fosofenadine and others.

In cases of resistance to the above group of drugs, it is necessary to use more severe hormonal therapy – glucocorticosteroids. But it is worth noting that drugs in this group have a large number of side effects, and their long-term use leads to irreversible consequences.

How to avoid allergy and its recurrence?

In order to prevent the development of sensitization to allergens, it is recommended to avoid contact with house dust, detergents, animal hair, chemicals at work and at home, etc.

Also, the usual rest in warm regions once a year can play a major role and protect the body from such a terrible pathology as allergies.

Rash on the palms of a child in the form of bubbles, pimples, blisters

A rash on the palms of a child for a mother should be a cause for alarm.There are many reasons that cause its appearance. To find out the nature, you will need to consult a pediatrician.

Various circumstances can provoke sores on the skin

Factors provoking rashes

The occurrence of a rash on the palms of a child that itches can be triggered by various factors. In infants, similar symptoms appear with allergies, especially during the period of introducing complementary foods. Sometimes sores, blisters and blisters signal serious pathologies.

Allergic reaction

The formation of hives on the palms indicates that the baby has been in contact with an allergen or has eaten a prohibited product.

Various products and substances can cause allergies:

90 170 90 171 sweets;

Note. Allergies are not only a bright red rash on the palms.Additionally, itching, runny nose, sneezing and other allergic symptoms are present.

Contact dermatitis

This is another type of allergic reaction, since contact dermatitis is triggered by contact with an allergen. The rash appears as red lesions. Blisters, blisters may occur. The skin constantly itches, pimples burst, forming wounds and cracks.

Cause contact dermatitis, in addition to the allergen, problems with the digestive, circulatory systems, various infections.

Skin lesions by parasites

Often, parasites and insects provoke the appearance of a rash on the hands. On small palms, an allergic rash may occur from traces of bites from wasps, bees, mosquitoes.

A tick can cause itching and a rash, it settles on the palms, in the folds of the skin, on the genitals. The disease is called scabies.

Note. Do not confuse rash with multiple mosquito bites, fleas and jellyfish burns. Insect marks can swell and the child will scratch them.

Viral infection

Rashes are a sign of developing infections. Symptoms characteristic of acute respiratory infections appear along with the rash. Most frequent infectious diseases:

1. Chickenpox. Small specks are formed, which gradually transform into bubbles no more than 5 mm in size. After a week, the pimples will disappear, leaving thin crusts.
2. Measles. Additionally, there are signs of infection (fever, cough, lethargy).The first sores appear on the head, then move to the palms, feet, trunk.
3. Coxsackie virus. A special type of infection, one of the symptoms of which is a rash.
4. Rubella. The first rashes form on the palm from the outside, the folds of the arms and legs. The sores are thick and small. It is accompanied by signs of intoxication.
5. Scarlet fever. First, the throat begins to hurt, as with sore throat, on the 2nd day there are small rashes.

Rubella is a common cause of rash

It will not be possible to do without medical care for infections, since incorrect diagnosis and treatment can provoke the development of complications.

Overheating, causing sweating

Banal lack of hygiene can provoke skin rashes. If you do not wash your baby in a timely and regular manner, then a prickly sweat initially appears. If the baby scratches the sores, infections and bacteria can get inside, which will provoke the formation of pustules.

For your information. Excessive wrapping of the baby can often provoke the formation of prickly heat.

Psoriasis and eczema

Eczema refers to pathologies with a neuro-allergic nature.Initially, small blisters may appear that itch. Gradually, they fill with pus. Usually, eczema is accompanied by the development of a bacterial-type infection.

Gradually, with eczema, instead of rashes, large areas of peeling appear

The development of psoriasis can cause rashes. Pathology, which is characterized by damage to the dermis and a chronic nature, is not infectious in nature. A small rash on the child’s palms and feet itches a lot. As a result of scratching, plaques are formed.

Other causes of rash

Often the cause of rashes is problems with the functioning of some internal systems of the body. If the circulatory system malfunctions, hemorrhagic rashes may appear on the hands, palms, and feet. The reason is the destruction of blood vessels and capillaries. Red blood cells seep through the skin, causing dark blotches to appear on the surface of the epidermis.

Note. This rash on the palms of a child and other parts of the body does not cause discomfort, but it signals possible pathologies.

Types of eruptions

The appearance of a rash on the palms does not go unnoticed by parents. Rashes may differ from each other in appearance:

1. Reddish bubbles. Most often, a colorless liquid collects under the upper layer of the epidermis.
2. Pimples. These are nodules hidden in the skin.
3. Pustules. The inside is filled with purulent fluid.
4. Blisters. They rise above the level of the skin, from above they are rough and dense in structure.
5. Ulcers and erosion.Skin lesions, which are characterized by various secretions.
6. Stains. Clusters at the level of the skin that differ in color from the skin.

If crusts begin to form at the site of the rash, then this is a signal of a gradual recovery.

What to do with a child’s rash

Any rash on the palms, feet, elbows, fingertips is a signal to parents. A consultation with a pediatrician will help. Only an experienced specialist correctly diagnoses the cause of the problem and prescribes the appropriate treatment.

It is not necessary to see a doctor if the mother understands for sure that the rash is a prickly rash or a known allergy.

Important points before the arrival of the pediatrician

If the child develops a rash, other possible symptoms should be diagnosed and reported to the doctor.

Possible additional signs of diseases:

90 170 90 171 temperature;

If a rash appears on the palms, the entire body and mouth of the baby should be checked, especially the feet and feet. The child with the rash is isolated from others until the cause is determined.

Need for medical attention

Call an ambulance if a child has a red rash on his palms accompanied by other symptoms:

• high temperature;
• vomiting or nausea;
• severe itching;
• lethargy and loss of appetite.

If there are no severe accompanying symptoms, but the causes and nature of the rash are not clear, then a trip to the pediatrician is required.

Diagnostics and treatment

If a rash appears on the palms, feet and the presence of other accompanying symptoms, only a medical institution will conduct a high-quality diagnosis. Through a series of analyzes, it is possible to identify the true cause of the problem.

The first diagnostic step is to examine the body for other lesions

Initial toddler will be examined by a doctor.General blood and urine tests are prescribed. If necessary, the child is referred to a dermatologist, he will write out directions for specific research.

Prevention

The likelihood of a rash in a child under one year old can be minimized by performing simple preventive measures:

1. Proper balanced diet, free of allergens.
2. Be sure to adhere to the daily routine.
3. From the first days of life, you need to teach your child to wash, wash his hands after the street, before eating.
4. All family members, including a newborn, should have their own personal hygiene items.
5. Avoid contact with strangers.
6. In cold weather, the use of mittens is mandatory.

Prevention is the best way to deal with potential problems

The most common cause of a rash on the feet and palms of a child is allergies, but other factors should not be ruled out. Avoiding problems is much easier than treating them later.If the rash provoked a disease, and its appearance is accompanied by other symptoms (fever, runny nose, disruption of the digestive system), then you should not hesitate. In this case, you cannot do without medical assistance.

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90,000 Photodermatosis: Common sun allergy

Summer solar dermatitis, often referred to as sun allergy, is the most common form of photodermatosis. This disease is caused by an increased sensitivity of the skin to ultraviolet light and is caused by exposure to sunlight.This phenomenon is not uncommon today – about 20% of the world’s population faces photodermatosis. Allergies appear as small, red, itchy dots. This usually happens after 12 hours. Relapses are often inevitable. Sun allergies can be more severe: more dots, more itching, and more affected areas.

Women between the ages of 15 and 35 are very often affected by sun allergies. It causes discomfort and negatively affects the appearance, is expressed in the appearance of small red spots, causing intense itching and burning.These spots usually do not appear on the face, but they are on the neck, shoulders, arms and legs. Other symptoms of photodermatosis: peeling of the skin, rashes in the form of papules or folliculitis (abscesses), prolonged pigmentation in the affected areas.

Symptoms often do not appear immediately. Unlike sunburn, photodermatosis can develop only a few hours after returning home (phototoxic reaction), and sometimes even several days later (photoallergic reaction).

The causes of photodermatosis are ultraviolet rays, especially UVA rays.Deodorants, perfumes, ointments and creams, which were applied to sensitive skin before going out in the sun, increase their negative effect. Some substances in perfumery and cosmetics can react with ultraviolet light and cause allergies. This property is possessed, for example, by eosin, contained in lipstick, and para-aminobenzoic acid, which is part of some sunscreens. Other substances have a similar effect: phenol, retinoids, salicylic, boric and polyunsaturated fatty acids, parsley juice, rose oil, bergamot, musk, St. John’s wort and sandalwood.

Often, the appearance of signs of allergy to the sun is caused by drugs. In particular: barbiturates, antihistamines, cytostatics, oral contraceptives, hormone replacement therapy drugs, sulfonamides, chlorpromazine, some cardiovascular drugs, certain antibiotics and certain anti-inflammatory drugs. An increased reaction to ultraviolet light is also manifested in the case of a decrease in the protective function of the skin due to additional effects on it (for example, peeling, cosmetic manipulations).Often the cause of photodermatosis is disruption of the hepatobiliary and gastrointestinal tract.

And there is only one way to solve this problem – to prevent its occurrence. The ideal solution is to avoid the sun or wear protective clothing. If the sun cannot be avoided:

• do not tan between 11.00 – 16.00
• Do not use perfumes or creams containing alcohol before visiting the beach
• tan gradually (20-30 minutes a day)
• Use a broad spectrum sunscreen with a strong protective factor (against UVA and UVB rays).The first days only on limited areas of the skin. And only after making sure that there is no occurrence of photodermatosis, when applying these funds to individual areas of the skin, use them on all surfaces of the skin.
• reapply the cream every two hours
• if it was still not possible to avoid the negative effects on the skin, and there is no way to see a doctor, you can remove acute manifestations of photodermatosis with the help of cold lotions and special after-sun products containing panthenol.It is better and more effective to seek help from a dermatologist or allergist.
• in the period of exacerbation of allergies, follow a hypoallergenic diet, exclude the intake of alcoholic beverages.

It is important to take every precaution to achieve the best result.

Urticaria in children – causes, symptoms, types, methods of diagnosis and treatment of urticaria in a child in Moscow in the clinic “SM-Doctor”

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Contents:
General information
Symptoms of urticaria in children
Causes of urticaria in children
Mechanism of urticaria (pathogenesis)
Classification of urticaria in children
First aid for urticaria in children
Treatment of urticaria in children
Possible complications and their consequences
Prognosis and prevention of urticaria

Urticaria is an allergic disease characterized by the appearance of a characteristic rash on the skin of a child or adult.It occurs against the background of an overreaction of the immune system to contact with conventional substances. The condition requires medical supervision and timely assistance when symptoms appear.

General

The name of the disease is due to the fact that outwardly it looks like a nettle burn – the skin turns pink and swells, while small blisters can merge into large local spots (angioedemas) of irregular shape. Papules cause itching and discomfort, when scratching, the wound surface can be infected, and then dermatitis and other complications join the underlying disease.

The disease is very common; every third inhabitant of the planet has had some form of urticaria.

Symptoms of urticaria in children

The main symptom of urticaria in a child is a rash. Its prevalence and severity may vary, but in most cases the disease follows a single pattern.

• Bulging rashes of pink and red appear, which turn pale when the skin is pressed or stretched. When the blisters merge, the edges of the spots are colored more intensely.
• The appearance of blisters, their disappearance or merging into large, shapeless foci occurs chaotically, and their migration over the surface of the body is unpredictable.
• The rash is accompanied by severe itching.
• Temperature may rise, both slightly and high.
• Often – weakness, malaise, joint pain and headache.
• In complicated form, shortness of breath or swallowing, nausea and vomiting, stool disturbances.
• An even more severe manifestation is Quincke’s edema on the lips, oral mucosa, eyelids, cheeks or genitals.

Localization of the appearance of the rash can be any, including on the mucous membranes – lips, in the nasopharynx, auricles on the genitals. Most often, the upper body and arms are affected, while the symmetry of the rashes is not always present, the spots take on the most bizarre coral-like outlines.

In most cases, allergy in the form of urticaria in children is accompanied only by the appearance of an itchy rash, which lasts for a short time, from several hours to several days.Often, other pathologies give similar symptoms, in this case, urticaria is not considered as an independent disease.

Information for parents! If the rash in the form of hives is accompanied by the appearance of even a slight swelling in the child, especially in the face and neck area, you must immediately call emergency help!

Causes of urticaria in children

There can be many reasons for the appearance of urticaria in a child. In addition, different factors can cause it in the same person at different ages.Among the most common pathogens in children, the following groups can be distinguished:

• Food products (citrus fruits, nuts, eggs, seafood, strawberries, tomatoes, etc.).
• Food additives, primarily sulfides, salicylates and various chemical dyes.
• Household allergens (dust, fluff, cigarette smoke, pollen of plants, cosmetics and detergents, synthetic clothing, fumes from furniture varnishes, paints, etc.).
• Medicines and contrast agents for radiography.
• Blood (donor) and preparations based on it.
• Vaccinations.
• Insect bites, helminthic infestations.
• Physical, including thermal phenomena (overheating and sweating, cold, physical activity, direct sunlight).
• Psychogenic factors.
• Various infections.

All of these factors can cause both primary urticaria and the impetus for its exacerbation in the chronic course of the disease.In children under the age of two, the vast majority of cases of urticaria are caused by a food allergen.

The mechanism of urticaria (pathogenesis)

The human body contains mast cells or mast cells, which are specific elements of connective tissues. They are the central element in the onset of urticaria, inflammation activators. When the allergen enters the body for the first time and in small doses, the child does not experience any external manifestations and reactions, but sensitization occurs, which can be presented as the first acquaintance with the allergen, as a result of which histamine is produced.It is this substance that causes redness, swelling and other factors of inflammation. Gradually, it accumulates in mast cells, and when its amount reaches a critical threshold, the cell membrane is destroyed with the release of histamine into the bloodstream and the subsequent cascade of pathological changes in the body.

Classification of urticaria in children

According to the nature of the course, an acute and chronic form is distinguished. In the first case, the disease manifests itself sharply, the symptoms of urticaria continue to bother the child from several hours (usually 6-12) to 1-2 weeks.The rash is accompanied by severe itching, the surface of the skin at the site of the rash becomes hot to the touch. If the outbreak is caused by an allergen, then when contact with it is eliminated, the symptoms disappear quickly and without a trace.

With exacerbation of chronic urticaria, itching and rashes are less intense, but in this case they can persist for a long period – several weeks, and sometimes months. The condition is accompanied by weakness, nausea, loss of appetite, headaches, less often – upset stools.Sometimes, against the background of sluggish urticaria, neurotic disorders develop, and since the child is constantly scratching the itchy papules, a secondary infection joins and dermatitis develops.

According to the severity of the disease, the following types of urticaria in children are distinguished.

• Mild form – external manifestations are almost invisible, the child feels well, itching and intoxication of the body are absent. A minor rash disappears within a maximum of a day.
• Medium – characteristic rashes are clearly visible, accompanied by fever and itching, intoxication of the body in the form of nausea and headache may be present.Papules merge, swelling appears, there is a risk of the first signs of Quincke’s edema.
• Severe – pronounced symptoms. Severely itchy rash, general intoxication of the body with a reaction of the gastrointestinal tract, the development of Quincke’s edema. Requires urgent medical attention.

Depending on the provoking factor, the child may experience the following types of urticaria:

• Contact – has an allergic origin, in 1st place among the reasons – pharmacological and biological factors.When contact with them is eliminated, it passes without a trace.
• Idiopathic – occurs for unknown reasons. Poorly responds to standard treatment, retains symptoms for a long time.
• Vibrating – occurs against the background of strong mechanical vibrations.
• Dermatographic – provoked by mechanical irritation of the skin (tight or synthetic clothing, skin folds, etc.). After removal of the irritant, it passes very quickly, usually within half an hour.
• Cholinergic – due to high physical activity, characterized by the appearance of small rashes.
• Thermal – provoked by uncomfortable (high or low) ambient temperature. Is accompanied by particularly severe itching, is the most common cause of edema
• Aquagenic – reaction to contact with water. The rash is usually mild or absent, but is accompanied by severe itching.

First aid for urticaria in a child

The primary task is to establish and eliminate the provoking factor.The main problem during this period is not rashes, but itchy skin. When providing first aid, it is important to eliminate it as much as possible – to cut your nails gently, put on protective gloves for babies, apply a non-hormonal anti-allergic cream (from sunburn, mosquito bites, etc.) to the rash site. If no cream is available, a cool compress can be used.

All this is done before medical assistance, which should be provided immediately. In case of development of edema and severe symptoms, it is necessary to call the emergency team.

Treatment of urticaria in children

The choice of tactics for treating urticaria in children depends on its cause, the main symptoms, the age of the child, and the stage at which the disease is caught.

A full-fledged therapy can only be prescribed by a doctor after an accurate diagnosis. The main tasks include eliminating provoking factors, prescribing drugs to eliminate symptoms, and treating comorbidities. The doctor makes the choice of antihistamines and other drugs on the basis of an individual clinical picture.Modern medicine offers new generation drugs that minimize the risk of side effects, have a high level of safety and ease of use for young children. In severe cases, hospitalization may be required.

Can a child with urticaria be bathed?

If the disease is not aquagenic in nature, it is possible and necessary to bathe the child, but it is important to follow the recommendations:

• do not heat water above + 37C;
• do not use washcloths and hygiene products with dyes and perfumes;
• maximum bathing time – 10 minutes;
• the use of decoctions of herbs and potassium permanganate should be agreed with the doctor;
• Do not rub the inflamed skin with a towel.

Possible complications and their consequences

Urticaria, with all its external harmlessness, can lead to serious consequences, primarily to Quincke’s edema. Its characteristic initial symptoms, in addition to the edema itself, are shortness of breath and a paroxysmal wheezing cough (bronchospasm). Edema of the internal mucous membranes is dangerous by disruption of the housing and communal services, the first signs of which are a gag reflex and a violation of the stool. On the part of the nervous system, severe cases of urticaria are dangerous with damage to the meninges, which can be fatal in the absence of medical attention.

Treatment of urticaria in children

It is impossible to predict the body’s reaction to this or that allergen, however, each parent can protect his child as much as possible from contact with the most active widely known allergens, do not wrap up or overcool, do not use cosmetics and detergents with dyes and strong fragrances. If possible, avoid the presence of children in rooms with a strong smell of paints and varnishes, avoid stress, infections and excessive physical exertion.It is recommended to examine the child’s endocrine system and not ignore the signs of weak immunity.

Unfortunately, urticaria is often not taken seriously, however, it is a disease that, if unfavorable, can threaten the life of a child.

Pediatricians “CM-Doctor” are always ready to help your child, their experience and attentive attitude to each little patient are the key to a quick and correct diagnosis and a well-chosen treatment tactics.

Doctors:

Children’s Clinic Metro Maryina Roscha

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Children’s Clinic Metro Voykovskaya

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Children’s clinic m.Novye Cheryomushki

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Children’s Clinic Metro Tekstilshchiki

Bozunov Alexey Viktorovich

Pediatric dermatologist, pediatric mycologist

Smoleva Maria Borisovna

Pediatric dermatologist of the highest category, pediatric mycologist, pediatric trichologist, pediatric cosmetologist

Korolkova (Simonovich) Polina Askoldovna

Pediatric dermatologist, pediatric trichologist, pediatric mycologist

Zueva Ksenia Mikhailovna

Pediatric dermatologist II category, pediatric mycologist, pediatric trichologist

Chekrygina Marina Vyacheslavovna

Children’s dermatologist, children’s mycologist, doctor of the highest category.Deputy Chief Physician for Medical Affairs in the Children’s Department at Volgogradsky Prospect

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Children’s clinic m.Youth

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Children’s clinic m.Chertanovskaya

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Children’s clinic m.VDNKh

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Children’s clinic in Solnechnogorsk, st.