Part II. Chronic Dermatitis of the Hands and Feet 


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Part II. Chronic Dermatitis of the Hands and Feet



Chronic dermatitis of the hands and feet includes a group of disorders in which the hands and feet are frequently inflamed and irritated.

Chronic dermatitis of the hands results from repetitive tasks, and contact with chemicals. Chronic dermatitis of the feet results from the warm, moist conditions in socks and shoes. Chronic dermatitis may make the skin of the hands and feet itch or hurt.

Contact dermatitis, one type of chronic derma­titis of the hands, usually results from irritation by chemicals (such as soaps) or by rubber gloves.

Pompholyx, a long-lasting condition that pro­duces itchy blisters on the palms and sides of the fingers, can also appear on the soles of the feet. The blisters are often scaly, red, and oozing. Pom­pholyx is sometimes called dyshidrosis, which means "abnormal sweating," but the condition has nothing to do with sweating.

Fungal infection is a common cause of an erup­tion on the feet, especially tiny blisters or deep red rashes. Sometimes, a person who has chronic fungal infection on the feet develops dermatitis on the hands because of an allergic reaction to the fungus.

Treatment

Treatment of chronic dermatitis depends on the cause. Most often, the best treatment is to remove the chemical that is irritating the skin. Corticosteroid creams can be applied to treat the inflammation. Bacterial infections that may develop in open skin sores are treated with antibiotics. When a fungus is causing the symptoms, an antifungal drug is used.

Notes:

confine ограничивать

occupational disease профессиональное заболевание

earlobe, lobe (of the ear) мочка уха

patches "очажки", "пэтчи" (мелкие скопления иммуноглобулиновых рецепторов на поверхности B-клеток после их сшивки антииммуноглобулином или бивалентным антигеном)

erup­tion сыпь, высыпание на коже

 

Text B. Atopic Dermatitis

 

Atopic dermatitis is a chronic, itchy inflammation of the upper layers of the skin that often develops in people who have hay fever or asthma and in people who have family members with these conditions.

People with atopic dermatitis usually have many other allergic disorders. The relationship between the dermatitis and these disorders isn't clear; some people may have an inherited ten­dency to produce excessive antibodies, such as immunoglobulin E, in response to a number of different stimuli.

Many conditions can make atopic dermatitis worse, including emotional stress, changes in temperature or humidity, bacterial skin infections, and contact with irritating clothing (espe­cially wool). In some infants, food allergies may provoke atopic dermatitis.

Symptoms

Atopic dermatitis sometimes appears in the first few months after birth. Infants may develop red, oozing, crusted rashes on the face, scalp, diaper area, hands, arms, feet, or legs. Often, the dermatitis clears up by age 3 or 4, although it commonly recurs. In older children and adults, the rash often occurs (and recurs) in only one or a few spots, especially on the upper arms, in front of the elbows, or behind the knees.

Although the color, intensity, and location of the rash vary, the rash always itches. The itching often leads to uncontrollable scratching, triggering a cycle of itching-scratching-rash-itching that makes the problem worse. Scratching and rub­bing can also tear the skin, leaving an opening for bacteria to enter and cause infections. For unknown reasons, people with long-term atopic dermatitis sometimes develop cataracts while in their 20s or 30s. In people with atopic dermatitis, herpes simplex, which usually affects a small area and is mild, may produce a serious illness with eczema and high fever (eczema herpeticum).

Diagnosis

Several visits to a doctor may be needed to establish the diagnosis. No test for atopic dermatitis exists. A doctor makes the diagnosis based on the typical pattern of the rash and often on whether other family members have allergies. Though atopic dermatitis may closely resemble seborrheic dermatitis in infants, doctors try to distinguish between them because their compli­cations and treatments are different.

Treatment

No cure exists, but certain measures can help. Avoiding contact with substances known to irri­tate the skin can prevent a rash.

Corticosteroid creams or ointments can relieve a rash and control itching. However, powerful corticosteroid creams applied over large areas or for a long time can cause serious medical problems, especially in infants, because these drugs are ab­sorbed into the bloodstream. If a corticosteroid cream or ointment appears to be losing its effec­tiveness, it may be replaced with petroleum jelly for a week or more at a time. Applying petroleum jelly or vegetable oil to the skin can help keep it soft and lubricated. When the corticosteroid is restarted after a brief break, it is more likely to be effective.

Some people with atopic dermatitis find that bathing worsens their rash; soap and water and even drying the skin, especially rubbing with a towel, may be irritating. For these people, bathing less often, lightly blotting the skin with a towel, and applying oils or unscented lubricants like moisturizing skin creams to the moist skin are helpful.

An antihistamine (diphenhydramine, hydroxyzine) can sometimes control the itching, partly by acting as a sedative. Because these drugs may cause sleepiness, they're most useful at bedtime.

Keeping fingernails short may help reduce skin damage from scratching and decrease the chance of infection. Learning to recognize the signs of atopic dermatitis skin infection (increased red­ness, swelling, red streaks, and fever) and seeking medical help as soon as possible are important. Such infections are treated with oral antibiotics.

Because corticosteroid tablets and capsules can produce serious side effects, doctors use them only as a last resort for people with stub­born cases. These oral drugs can stunt growth, weaken bones, suppress the adrenal glands, and cause many other problems, especially in children. Also, their helpful effects are only shortlived.

For unknown reasons, ultraviolet light treatment plus oral doses of psoralen, a drug that intensifies the effects of ultraviolet light on the skin, may help adults. This treatment is rarely recommended for children because of its potential long-term side effects, including skin cancer and cataracts.

Notes:

humidity сырость, влажность

petroleum jelly вазелин; петролатум

rubbing вытирание

blotting промакивание

lubricant смазочный материал, смазка

moisturizing skin cream увлажняющий крем

stub­born прочный, стойкий, упорный



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