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Random EXCEMA, dry and cracking with itching. Treatment?

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Gets random excema on hands at different times, started out as, then got really dry and cracking. Then almost went away and then was put in a stressful situation it came back. Citrus irritates it and cleaner. It's itchy and I don't know what to do? It's never been like this before, it's so dry and parts just start breaking and opening

Category: Dermatologist

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Kalpana Pathak is online now

Expert:  Dr. Kalpana Pathak replied 4 Days.

Thanks for writing to us
You probably have contact dermatitis. In simpler words eczema of hands. There could be multiple causes of hand eczema like exposure to irritant chemicals, soaps, detergents, vegetables, chalk, fertilizer, cement etc. As you are a chef, frequent exposure to detergents, spices, edibles like onion, garlic, citrus fruits/vegetable, chillies etc may irritate your skin.
Right now I can see a well defined wet lesion with small cuts and fissures. Now to treat the same, We usually prescribe a potent steroid antibiotic combination like halobetasol fusidic acid combination twice in a day. Taking an oral antiallergic like desloratidine twice daily would relieve the itch. One should wear gloves while working and avoid use of harsh detergents. Using mild soap like cetaphil to wash hands would help in keeping skin soft. Also a paraffin based moisturiser should be used once the lesion heals and is dry. You may follow the same for a week and then you may get back for follow up. Once the lesion dries, we change topical cream to help the lesion resolve completely.
If no response is seen or if lesion is persistent then fungal infection of hands should be ruled out
Hope this helped. Should there be any query, please write back

Take care

Patient replied :

If it was gone almost and just was slightly red 10 days ago. And then came back and the lesion stay for awhile, then what is the problem? It's different then any excema I've ever had, and it doesn't want to go away. When I've had if for awhile and it seems almost healed but has a giant red outline it starts again

Expert:  Dr. Kalpana Pathak replied 3 Days.

Thanks for writing back.
Hand Eczema can be recurrent as one cant avoid all the causative or precipitating factors. In your case, continous exposure to detergents and irritant vegetable exudate could be the precipitating cause. So you can have a waxing and waning type of eczematous lesions. Right now, I would advise you to follow the guidelines mentioned in my previous post. Please get back for follow up after a week with a pic of affected area.
Hoping to hear from you after a week.
Take care

Dr. Kalpana Pathak
Category: Sexually Transmitted Diseases(STD)Specialist
M.D. from Pt. B D Sharma Postgraduate Institute of Medical Sciences, Rohtak in 2011 with Haryana State Dental & Medical Council
M.B.B.S from MLN medical college allahabad in 2006 with Uttar Pradesh Medical Council
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