Hand Eczema (Developer Coaching Client)

Diagnosis: Hand Eczema (Developer Coaching Client)

Developer with hand eczema and compromised skin lipid barrier. Constant handwashing and lack of barrier protection

Clinical Presentation

Developer with hand eczema and compromised skin lipid barrier. Constant handwashing and lack of barrier protection

Clinical History

Submitted by Marisa. Originally posted January 23, 2020.

Treatment

See case discussion.

Differential Diagnosis

• Psoriasis • Contact dermatitis • Scabies • Tinea corporis • Seborrheic dermatitis • Mycosis fungoides • Drug eruption

Key Learnings

• "Eczema" is a clinical pattern, not a single diagnosis — encompasses multiple subtypes • Impaired skin barrier function is central to pathogenesis • Spongiosis (intercellular edema in epidermis) is the histological hallmark • Acute: vesicles, weeping. Subacute: erythema, scale. Chronic: lichenification, fissuring • Superinfection with S. aureus is common and may cause flares

Tags: hand, eczema, developer, coaching, client, marisa