What's Causing This Woman's Itchy, Painful, Fissured Fingers And Palms?


A 34-year-old woman presented with mildly pruritic and somewhat painful hands of approximately 6 months’ duration. She had been seen by a physician, who had prescribed her a midpotency topical corticosteroid and a moisturizer that provided modest relief.
She had 3 young children and was preoccupied with housework, including cooking and laundry. She had a history of childhood atopic dermatitis.

Physical examination revealed xerosis, scaling, and fissuring of the digits and palms. There were no skin lesions in other locations. The rest of the physical examination findings, particularly in the nails and joints, were normal.

What’s Your Diagnosis?

    A. Tinea manuum
    B. Hand eczema
    C. Palmar psoriasis
    D. Palmoplantar pustulosis

To learn the answer, go to page 2

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