Hands

The hands are a common site for dermatitis. This area remains a diagnostically complex region due to the multifactorial nature of hand dermatitis. Contact dermatitis has been reported to be the most common type of dermatitis involving the hands. Several studies have highlighted that hand dermatitis is common among people in occupations involving wet work or exposure to soaps or cleansers. Risk factors include the use of gloves and chemical exposure. Wet work is also a very important risk factor for hand dermatitis. The thinner skin of the dorsal hand and wrists tends to show a patchy dermatitis, while there is relative sparing of the palmar skin. An isolated and patterned or geometric dermatitis of the hands should initiate a Sherlock Holmes–like approach to obtaining possible contactant history. While systemic ingestion of foods high in nickel has been associated with dyshidrosis, hand dermatitis related to metals is more often due to the handling of metal-containing instruments or wearing metal jewelry.