BACKGROUND: Palmoplantar pustulosis (PPP) and pompholyx are both chronic vesiculopustular conditions of the palms and soles. Because both share similar clinical and histological features, it is difficult even for dermatologists to differentiate between these two diseases. OBJECTIVE: To analyze clinical features that can be helpful in differentiating the two diseases. METHODS: The clinical history of 133 patients with vesicles or pustules on the palms and/or soles was evaluated. Patients were divided into a PPP group and a pompholyx group. RESULTS: There was no sex or age predilection in either group and no significant difference in overall localization and symmetry of lesions. Bilaterality was found in 75.0% of cases of PPP and 82.0% of cases of pompholyx. More lesions were found on the tip of the finger/toe, and the side of the toe in the pompholyx group than in the PPP group. However, there was no difference between two groups in lesions on the sides of fingers. More cases of PPP involved right distal interphalangeal (DIP) and bilateral proximal interphalangeal (PIP) joint areas compared with pompholyx. There were more smokers in the PPP group. Among several comorbidities, only atopic dermatitis and nummular eczema were associated with pompholyx. CONCLUSION: Several characteristics of patients and clinical findings may serve as useful “clues” to differentiate between and determine treatment for PPP and pompholyx.
Comorbidity ; Dermatitis, Atopic ; Diagnosis, Differential* ; Eczema ; Eczema, Dyshidrotic* ; Fingers ; Humans ; Joints ; Toes

No abstract available.
Eczema, Dyshidrotic* ; Pigmentation*

Tinea manuum comprises roughly 5% of all cases of tinea, and the main culprit is known to be Trichophyton (T.) rubrum, T. mentagrophytes var. erinacei is a dermatophyte that may be transmitted from hedgehogs, and it has been reported in Korea now that vast diversity of pets are brought into existence. Tinea manuum caused by T. mentagrophytes var. erinacei, is frequently localized to the initial site of exposure, and thus may be confused with hand eczema or pompholyx. The patient visited the outpatient clinic with an erythematous scaly patch with pustule on the right finger after being initially misdiagnosed with housewife eczema. Numerous hyphae were evident on KOH smear examination, and confirmative diagnosis of tinea manuum caused by T. mentagrophytes var. erinacei was made after culturing scales from the lesion for molecular biological analyses. The patient is currently under follow-up without relapse after being treated systemic and topical antifungal agents.
Ambulatory Care Facilities ; Antifungal Agents ; Arthrodermataceae ; Eczema ; Eczema, Dyshidrotic ; Fingers ; Follow-Up Studies ; Hand ; Hedgehogs ; Humans ; Hyphae ; Korea ; Recurrence ; Tinea ; Trichophyton ; Weights and Measures

Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN.
Biopsy ; Eczema, Dyshidrotic ; Extremities ; Genitalia ; Humans ; Lichen Nitidus ; Lichens ; Pruritus ; Skin

BACKGROUND: Hand eczema is a common skin disease in the general population. The etiology of hand eczema is obscure and many causative factors have been proposed. However, there are only a few reported studies of the relevance of contact allergy in hand eczema. Objective: The purpose of this study was to evaluate the diagnostic value of the patch test for patients with hand eczema. METHODS: We analyzed the clinical characteristics and the results of the patch tests of the 37 patients with hand eczema and we then compared these with the clinical subtypes. RESULTS: 26 patients (70.3%) showed a positive test to one or more allergens. The common allergens were nickel sulfate (35.1%), mercury ammonium chloride (21.6%), and cobalt chloride (18.9%). The positive rates for a patch test were 82.4% for the vesicular form, 77.8% for the fissured form, 20.0% for the hyperkeratotic form and 66.7% for pompholyx, respectively. We found more significant improvement of the clinical symptoms in the vesicular group (57.1%) than that in the non-vesicular group (9.3%) after avoiding the verified allergens. CONCLUSION: This study shows that the patch test is a useful tool for the detection of contact allergens and it must be performed for the patients with hand eczema, and especially for those patients with the vesicular type.
Allergens ; Ammonia ; Ammonium Chloride ; Cobalt ; Dermatitis, Allergic Contact ; Eczema ; Eczema, Dyshidrotic ; Hand ; Humans ; Hypersensitivity ; Mercuric Chloride ; Nickel ; Occupations ; Patch Tests ; Skin Diseases

BACKGROUND: Hand eczema is a common skin disease in the general population. The etiology of hand eczema is obscure and many causative factors have been proposed. However, there are only a few reported studies of the relevance of contact allergy in hand eczema. Objective: The purpose of this study was to evaluate the diagnostic value of the patch test for patients with hand eczema. METHODS: We analyzed the clinical characteristics and the results of the patch tests of the 37 patients with hand eczema and we then compared these with the clinical subtypes. RESULTS: 26 patients (70.3%) showed a positive test to one or more allergens. The common allergens were nickel sulfate (35.1%), mercury ammonium chloride (21.6%), and cobalt chloride (18.9%). The positive rates for a patch test were 82.4% for the vesicular form, 77.8% for the fissured form, 20.0% for the hyperkeratotic form and 66.7% for pompholyx, respectively. We found more significant improvement of the clinical symptoms in the vesicular group (57.1%) than that in the non-vesicular group (9.3%) after avoiding the verified allergens. CONCLUSION: This study shows that the patch test is a useful tool for the detection of contact allergens and it must be performed for the patients with hand eczema, and especially for those patients with the vesicular type.
Allergens ; Ammonia ; Ammonium Chloride ; Cobalt ; Dermatitis, Allergic Contact ; Eczema ; Eczema, Dyshidrotic ; Hand ; Humans ; Hypersensitivity ; Mercuric Chloride ; Nickel ; Occupations ; Patch Tests ; Skin Diseases

Intravenous immunoglobulin therapy has been used to treat various immune-mediated diseases. Its utility in dermatology continues to expand, including treatment for autoimmune blistering disease, graft-versus-host disease, and dermatomyositis. It is generally considered safe, and serious adverse effects such as anaphylaxis, renal tubular necrosis or aseptic meningitis rarely occur. Furthermore, adverse skin reactions very rarely occur, but can include urticaria, pruritus, eczema, alopecia, lichenoid dermatitis or pompholyx. We describe a case of a 48-year-old man who developed vesicular eczema on his palms and soles after administration of intravenous immunoglobulin therapy for encephalomyelopathy.
Alopecia ; Anaphylaxis ; Blister ; Dermatitis ; Dermatology ; Dermatomyositis ; Eczema ; Eczema, Dyshidrotic* ; Graft vs Host Disease ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Meningitis, Aseptic ; Middle Aged ; Necrosis ; Pruritus ; Skin ; Urticaria

BACKGROUND: Palmoplantar dermatoses have frequently been encountered in the dermatologic field. Many previous studies have focused on the specific diseases of palmoplantar dermatoses; however, none of them have included a the comprehensive study of palmoplantar dermatoses. OBJECTIVE: The purpose of this study was to investigate the epidemiological aspects of palmoplantar dermatoses, with a brief review of the common palmoplantar dermatoses. METHODS: We retrospectively reviewed the data of 237 patients who had been biopsied for palmoplantar dermatoses between January 2000 and December 2004 at Our Lady of Mercy Hospital, The Catholic University of Korea. RESULTS: The results were as follows; Female to male ratio was 1 : 1.01. The mean age at diagnosis was 37.5+/-20.1 years. The mean duration of the disease was 35.9 months and ranged from 2 days to 50 years. Palmoplantar dermatoses appeared on the palms in 49 (20.6%) patients, the soles in 123 (51.9%) patients, and both the palms and soles in 65 (27.4%) patients. The most common five diseases of palmoplantar dermatoses were palmoplantar pustulosis (23.2%), verruca (11.4%), pompholyx (10.1%), palmoplantar keratoderma (8.9%), and contact dermatitis (8.0%). Of the 237 patients, 65 (27.4%) patients were accompanied with other dermatoses; fungal infection (13.9%), eczema (7.6%), onychodystrophy (3.4%), psoriasis (1.7%), erythema multiforme (1.3%), hyperhidrosis (1.3%), drug eruption (0.8%), or lichen simplex chronicus (0.4%). Of the 237 patients, 51 (21.5%) patients were accompanied with systemic diseases; Cardiovascular diseases (8.4%), endocrine diseases (6.6%), hepatobiliary diseases (4.6%), malignancy (3.4%), pulmonary diseases (2.5%), or gastrointestinal diseases (1.3%). CONCLUSION: Our study shows that the biopsy of palmoplantar dermatoses is gradually increasing. Further investigation with a wider and larger population is necessary to understand the epidermiology of palmoplantar dermatoses, and, based on the epidermiology of palmoplantar dermatoses, accurate diagnosis and proper treatment of palmoplantar dermatoses could then be achieved.
Biopsy ; Cardiovascular Diseases ; Dermatitis, Contact ; Diagnosis ; Drug Eruptions ; Eczema ; Eczema, Dyshidrotic ; Endocrine System Diseases ; Erythema Multiforme ; Female ; Gastrointestinal Diseases ; Humans ; Hyperhidrosis ; Keratoderma, Palmoplantar ; Korea ; Lung Diseases ; Male ; Neurodermatitis ; Psoriasis ; Retrospective Studies ; Skin Diseases* ; Warts

No abstract available.
Eczema, Dyshidrotic* ; Guillain-Barre Syndrome* ; Immunization, Passive* ; Immunoglobulins*

BACKGROUND: Local bath-PUVA(LB-PUVA) therapy has been recently tried for the treatment of palmoplantar pustular psoriasis and chronic eczema with successful results. However it has not been reported that the effectiveness of LB-PUVA was compared with that of steroid treatment which is the most available treatment. OBJECTIVES: The purpose of this study was to assess the effectiveness, symptom-free interval, recurrence rate and side effects of local bath-PUVA(LB-PUVA) therapy in palmoplantar pustular psoriasis and dyshidrotic eczema which had been resistant to conventional treatments and to compare these results with those of the steroid treatment. METHODS: Twenty four patients with palmoplantar pustular psoriasis, dyshidrotic eczema and palmoplantar keratoderma were treated with local bath-PUVA and the control group of twenty patients with systemic and topical steroid. 1. Local bath-PUVA therapy After a 15-minute bath in 1mg/L of methoxsalen solution(0.0001%), the palms or soles or both were exposed immediately to UVA radiation by UV/PUVA200. The initial standard dose was 1.5 J/cm2, and the patients were treated three times a week. 2. Systemic and topical steroid therapy The patients treated with 10-15mg of oral prednisolone once a day and high-potency steroid(Dermovate ointment) to the lesion topically for 4-8 weeks. The efficacy, symptom-free interval and side effects were assessed for 6-12 months after termination of the treatments. RESULTS: The following results were obtained from this study. 1. In the objective study, severity scores before and after treatment significantly differed in palmoplantar pustular psoriasis treated with local bath-PUVA (p<0.001). 2. In the subjective study, steroid treatment was more effective than LB-PUVA treatment for dyshidrotic eczema and palmoplantar pustular psoriasis. 3. Remission period was significantly longer (mean 9.1+/-2.8 months vs. 5.2+/-3.1 months) and recurrence rate, lower (26.7% vs. 68.9%) after LB-PUVA treatment than after steroid treatment in palmoplantar pustular psorisis and dyshidrotic eczema. 4. One patient with palmoplantar keratoderma was effectively treated by LB-PUVA. CONCLUSION: Local bath-PUVA therapy can be used as an effective and safe treatment method of palmoplantar pustular psoriasis and possibly palmoplantar keratoderma.
Baths ; Eczema ; Eczema, Dyshidrotic* ; Humans ; Keratoderma, Palmoplantar ; Methoxsalen ; Prednisolone ; Psoriasis* ; Recurrence