What Does Eczema Look Like On Your Feet – Actas Dermo-Sifiliográficas is the official publication of the Spanish Academy of Dermatology and Venereology (AEDV). Founded in 1909, Actas Dermo-Sifiliográficas is the oldest monthly medical journal published in Spain. In 2006, it was indexed in the Medline database and became one of the most up-to-date and modern means of expression for Spanish medicine. All articles are subjected to a rigorous process of professional evaluation and careful proofreading, both literary and scientific. In addition to the classic parts Originals and Clinical cases, reviews, Diagnostic cases and Book criticism stand out. In short, Actas Dermo-Sifiliográficas is an essential publication for anyone who needs to be up-to-date on all aspects of Spanish and world dermatology.
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What Does Eczema Look Like On Your Feet
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Pompholox Eczema, Athletes Foot, Or Shingles
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Considering the numerous publications devoted to hand eczema, chronic foot eczema has received little attention in recent years. However, chronic leg eczema is also a common problem, which can limit activity in some patients. The introduction of new therapeutic options such as alitretinoin for the management of chronic hand eczema resistant to conventional treatment led us to choose this drug in a patient with intractable chronic leg eczema. A 49-year-old woman with atopy and allergy to various nonsteroidal anti-inflammatory drugs was examined in our clinic for a 5-year history of eczema on both legs. She was treated with emollients, high-potency topical corticosteroids, and several courses of oral corticosteroids with modest improvement (Fig. 1). The eczema caused constant itching coupled with pain that sometimes disrupted her sleep and caused her to miss work at times. Figure 1. A, Appearance of eczema on the feet. B, Lateral view. (0.27 MB). Standard patch testing according to the guidelines of the Spanish Research Group for Contact Dermatitis and Skin Allergy (GEIDAC) was positive for chromium, thiomersal and caines. A skin biopsy showed subacute spongiotic dermatitis and microbiological cultures were negative. After failure of treatment with topical calcineurin inhibitors (tacrolimus and pimecrolimus), treatment was started with oral cyclosporine at a dose of 3 mg/kg/day in 2 daily doses, with poor response after 12 weeks. In addition, the patient used chrome-free shoes. She was then treated with acitretin, 25 mg/day, which was discontinued after 1 month because of hypertriglyceridemia in follow-up blood tests; there was no response. Due to this lack of improvement, off-label use of alitretinoin was requested and treatment was started at 30 mg/day with a good response after the first week of treatment; Complete resolution of the lesions was achieved after 1 month (Fig. 2), and therefore treatment was discontinued. There were no adverse effects and no changes in blood tests. During the third month of treatment-free follow-up, the patient developed another flare and alitretinoin treatment was restarted at 30 mg/day and continued until remission was achieved. Subsequently, she received the same dose every other day and continued this regimen for 6 months, maintaining almost complete resolution of the lesions and a significant improvement in quality of life. Figure 2. Complete resolution after 4 weeks of alitretinoin treatment. (0.41 MB). There are geographic differences in the incidence of chronic eczema on the legs, and in a large proportion of cases it appears to be related to atopic eczema.1 In general, there is a high prevalence of dermatoses affecting the legs. However, some aspects, such as their impact on quality of life, have not been sufficiently explored. A large study found that a significant percentage of patients with foot dermatoses experience pain, discomfort when walking, and even embarrassment and limitations in activities of daily living.2 Treatment is usually similar to that of chronic hand eczema and includes emollients, topical corticosteroids, and calcineurin inhibitors; Systemic treatment included corticosteroids, traditional retinoids, cyclosporine, and UV radiation. Alitretinoin (9-cis-retinoic acid) is an isoform of isotretinoin (13-cis-retinoic acid), a retinoid that was specifically developed and approved for the treatment of chronic hand eczema. The exact mechanism of action of alitretinoin in chronic eczema is not known, but it may interfere with at least 2 stages of the inflammatory process. In the early stages, it could interfere with the production of chemokines, reduce the migration of leukocytes and can also act in the leukocytes themselves, changing the activation of leukocytes modulated by antigen-antibody presentation.3 The efficacy of alitretinoin in chronic hand eczema resistant to topical corticosteroids has been demonstrated in a large double-blind study4 ; the dose that produced the best response was 30 mg/day, with up to 24 weeks of clearance in 48% of patients compared with 28% of patients on 10 mg/day and 17% of patients on placebo; the average response time was 12.1 weeks. These results are consistent with those of a recent case series published in Spain.5 In a study by Ruzicka et al.4, lesion recurrence occurred in up to a third of patients who initially responded to alitretinoin after 24 weeks of follow-up. . A recent study reported that a second course of alitretinoin 30 mg/day in relapsed patients achieved clearance in up to 80% of cases with good tolerance6; this would suggest that this drug could be used for the long-term treatment of chronic hand eczema. Alitretinoin is therefore a useful and probably cost-effective treatment for this condition.7 We report a case of a patient with chronic foot eczema that did not respond to various traditional treatments. Alitretinoin achieved complete resolution of the eczema. Alitretinoin could be a useful alternative in the treatment of patients with chronic leg eczema.
Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicenter study.
Response to treatment with oral alitretinoin in refractory NDE with chronic hand eczema refractory to treatment with potent topical corticosteroids: our experience in 15 patients.
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Please cite this article as: Tejera-Vaquerizo A, et al. Successful treatment of recalcitrant chronic plant eczema with alitretinoin. Proceedings of Dermosifiliogr. 2012;103:931–2. Dyshidrotic eczema is a skin condition that causes small blisters on the palms, soles, and edges of the fingers and toes. While the exact cause of dyshidrotic eczema is unknown, it is more common in people who have another form of eczema and tends to run in families, suggesting a genetic component.
This common form of eczema, also called pompholyx (meaning “bubble” in ancient Greek), hand and foot eczema, palmoplantar eczema and vesicular eczema, is more common in women than in men.
Dyshidrotic eczema is most common in younger adults, usually between the ages of 20 and 40. People can have a single flare-up of dyshidrotic eczema, but it’s more common for it to come and go over a long period of time.
Metals, especially nickel, are a common trigger. Stress can also cause flare-ups. Detergent can cause a fire. The condition is also associated with seasonal allergies, such as hay fever, and hot, humid weather. Sweaty palms can trigger a rash, as can work such as hairdressing or health care that involves frequent wetting of hands. Any external trigger or irritant that affects your immune system can also affect your skin. Hand dermatitis includes not only dyshidrotic eczema, but can also refer to a wider range of skin conditions that are triggered by environmental irritants and allergens; atopic dermatitis can also lead to eczema breakouts along the skin of the hands.
Weeping Eczema: Symptoms, Causes, Treatment, And Prevention
Flare-ups occur only on the hands and feet and usually begin with a rash of painful, deep-seated blisters called vesicles, although sometimes itching and burning sensations begin first. As the blisters heal, the skin becomes dry and often red and scaly. This leaves it soft and dry and sometimes creates painful cracks or fissures. The skin can also become infected.
Knowing your triggers and maintaining a regular skin care routine can help prevent and manage dyshidrotic eczema flare-ups. Helpful steps may include:
Dermatologists can usually diagnose dyshidrotic eczema using a skin exam and medical history. Many cases improve quickly with a short course of topical corticosteroids combined with soaking or applying cold compresses to the affected areas several times a day to help dry up the blisters. Because this form of eczema is sometimes associated with a fungal infection on the hands or feet, your dermatologist may prescribe
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