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Background@#Hand eczema refers to eczema located on the hands, regardless of its etiology or morphology. Despite its high prevalence and significant impact on patients’ quality of life, treatment is frequently challenging because of its heterogeneity, chronic and recurrent course, and lack of well-organized randomized controlled trials of the various treatment options. @*Objective@#These consensus guidelines aim to provide evidence-based recommendations on the diagnosis and management of hand eczema to improve patient care by helping physicians make more efficient and transparent decisions. @*Methods@#A modified Delphi method, comprising two rounds of email questionnaires with face-to-face meetings in between, was adopted for the consensus process that took place between February and September 2020. Forty experts in the field of skin allergy and contact dermatitis were invited to participate in the expert panel. @*Results@#Consensus was reached for the domains of classification, diagnostic evaluation, and treatment; and a therapeutic ladder to manage chronic hand eczema was developed. @*Conclusion@#These are the first consensus guidelines for chronic hand eczema in the Asian population, which will help standardize care and assist clinical decision-making in the diagnosis and treatment of chronic hand eczema.
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Background@#Hand eczema refers to eczema located on the hands, regardless of its etiology or morphology. Despite its high prevalence and significant impact on patients’ quality of life, treatment is frequently challenging because of its heterogeneity, chronic and recurrent course, and lack of well-organized randomized controlled trials of the various treatment options. @*Objective@#These consensus guidelines aim to provide evidence-based recommendations on the diagnosis and management of hand eczema to improve patient care by helping physicians make more efficient and transparent decisions. @*Methods@#A modified Delphi method, comprising two rounds of email questionnaires with face-to-face meetings in between, was adopted for the consensus process that took place between February and September 2020. Forty experts in the field of skin allergy and contact dermatitis were invited to participate in the expert panel. @*Results@#Consensus was reached for the domains of classification, diagnostic evaluation, and treatment; and a therapeutic ladder to manage chronic hand eczema was developed. @*Conclusion@#These are the first consensus guidelines for chronic hand eczema in the Asian population, which will help standardize care and assist clinical decision-making in the diagnosis and treatment of chronic hand eczema.
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Linear atrophoderma of Moulin is a rare acquired atrophic skin condition following the lines of Blaschko. It is characterized by asymptomatic, band-like, hypopigmented atrophoderma, without obvious induration or sclerosis. Usually, the lesions begin in childhood or adolescence and are localized on the trunk or extremities with a unilateral distribution. Extensive lesions with bilateral involvement are extremely rare, and only three cases affecting patients bilaterally have been previously described. We herein present the case of a 17-year-old boy with multiple hyperpigmented atrophic patches, arranged in a linear pattern on both sides of the trunk, right buttock and leg, and left arm.
Assuntos
Adolescente , Humanos , Braço , Nádegas , Extremidades , Perna (Membro) , Esclerose , PeleRESUMO
Eosinophilic cellulitis is also called Wells' syndrome, and this is an acute pruritic dermatitis that resembles cellulitis. It usually appears as well-circumscribed erythematous plaques, but bullous lesions have rarely been reported. There are several precipitating factors, including drugs, arthropod bites, viral infections, parasitic infestations, leukemia and other malignancies. A 21-year-old male presented with a mildly pruritic vesiculobullous eruption on the dorsum of left foot after he had been pricked by a twig. Histopathologic examination showed intraepidermal blisters and spongiosis of the epidermis and a mixed inflammatory cell infiltration that consisted mostly of eosinophils throughout the dermis. These findings were consistent with the diagnosis of bullous eosinophilic cellulitis. He was treated daily with prednisolone 30 mg and the lesions rapidly resolved. There has been no recurrence of the lesions for 1 year of follow-up.
Assuntos
Humanos , Masculino , Adulto Jovem , Artrópodes , Mordeduras e Picadas , Vesícula , Celulite (Flegmão) , Dermatite , Derme , Eosinofilia , Eosinófilos , Epiderme , Seguimentos , Pé , Leucemia , Fatores Desencadeantes , Prednisolona , RecidivaRESUMO
Verrucous cyst is a rare form of epidermal cyst showing verrucous changes of their stratified squamous epithelial lining, characterized by papillomatosis, acanthosis, and hypergranulosis with large, irregular keratohyaline granules. In addition, vacuolated keratinocytes, parakeratosis, and squamous eddies are often present. Herein, we describe a 45-year-old woman with a verrucous cyst, which occurred on left axilla three months ago, showing the above-mentioned characteristic histologic features. Both the immunohistochemical stain and polymerase chain reaction for the common antigen for human papillomavirus and DNA chip study for the human papillomavirus were negative.