Use of a semipermeable glove during treatment of hand dermatitis.

Forty-six subjects with hand dermatitis participated in a pilot study comparing a new semipermeable glove to a standard cotton glove. A variety of diagnoses were represented. Each subject received treatment with topical steroids and/or moisturizers and used one each of the experimental and cotton gloves for approximately one month. Physicians scored skin condition before and after treatment. Subjects evaluated skin comfort and practical aspects of using each type of glove. Thirty subjects completed the study protocol. The type of glove used had no impact on skin condition at follow up, with both groups of hands improving. Patients expressed a preference for the experimental gloves, noting improvements in skin and hand comfort, dexterity, cleanliness, and ease of use. Feedback suggested that the gloves will be well tolerated and patient compliance in using the gloves will be high. Evaluation of the gloves' value for prevention and chronic management of hand dermatitis is warranted.

Choosing a local anesthetic.

Although lidocaine alone will serve as an excellent anesthetic for most patients, using less painful injectable agents, topical anesthetics, and occasionally oral sedation will offer the frightened or pain-intolerant patient an acceptable and effective alternative system of local anesthesia. The pain-tolerant patient will also appreciate the reduced discomfort experienced when these products and techniques are employed. Uses and practical considerations of the agents in this system are summarized in Table 2.

Options for painless local anesthesia.

Fear of the needle is a real issue with some patients and may be an obstacle to inducing anesthesia before minor surgical procedures are performed. Adults may express this fear verbally or, out of embarrassment, even avoid coming to the physician's office. Children may become intensely anxious and hysterical. In this article, Dr Holmes describes the use of alternative procedures and agents for reducing the pain of inducing anesthesia and thus reducing patients' anxiety.

Stings and bites. Tips on coexisting comfortably with the insects.

Many stings and bites can be prevented if an individual has some knowledge of insect behavior. However, persons known to be allergic to insect stings should carry an epinephrine injection kit to use as a first aid measure. Those who travel far from medical facilities should additionally carry prednisone and oral antihistamines. The bite of a brown recluse spider may cause a minor reaction or it may evolve into extensive soft-tissue necrosis with a potentially fatal outcome. If necrosis occurs, a course of oral dapsone is recommended.

Cutaneous cartilaginous tumor.

A histologic diagnosis of cartilaginous tumor was made from solitary nodular skin lesions of two patients. Lack of information about cartilage tumors in the dermatologic literature suggests that they rarely develop as superficial lesions. Despite a high incidence of nuclear changes suggesting malignant neoplasm, the majority behave in a benign fashion and can be treated conservatively.