Hand Dermatitis


Hand Dermatitis, Foot Dermatitis, Distal Extremity Rash, Acral Skin Lesion, Palm and Sole Desquamation, Palm and Sole Pustules, Palmoplantar Rash

  • Causes
  • Erosion and excoriation
  1. Impetigo or super-infected dermatitis (most common)
    1. Treat with Dicloxacillin or Erythromycin x7-10 days
  2. Scabies
  1. Bacterial Infection (Most common)
    1. Staphylococcus aureus most common cause
  2. Fungi (dermatophytes, tinea)
  3. Psoriasis
  4. Old Blisters collecting debris
  • Causes
  • Solitary or scattered Pustules
  1. Bacterial Infection or Sepsis
    1. Consider NeisseriaGonorrhea, Candida
    2. Culture!
    3. Suspect Sepsis with Hemorrhagic Pustules
  2. Sporotrichosis
  3. Herpes simplex (whitlow)
  1. Psoriasis
  2. Secondary Syphilis
  3. Reiter's Syndrome
  4. Bowen's disease (Squamous Cell Carcinoma in situ)
  5. Discoid Lupus (scarring)
  6. Tinea does not usually present with multiple lesions
  7. Palmoplantar Pustulosis (Pustular Psoriasis)
  • Causes
  • Pigmented lesions
  1. Acral Lentiginous Melanoma
  2. Racial trait
  3. Postinflammatory pigment
  • Causes
  • Painful palm and sole lesions
  1. Bacterial Endocarditis
    1. Osler Nodes (Painful raised lesions on palms and soles)
    2. Janeway Lesions (Painless hemorrhagic Nodules on palms or soles)