Unilateral Hand Eczema

Abstract

Background: Recently, increasing numbers of cases with unilateral hand eczema with quite resemblance and difficult to differentiate from Tinea mannum (a superficial fungal infection of the hand) are seeking dermatology clinic. Some of which wasn’t respond to conventional antifungal therapy instead they show a substantial response to topical steroid.

Aim of the study: To assess the real presence of unilateral hand eczema in patients presented with unilateral hand scaly dermatoses.

Patient and methods: This study is cross sectional descriptive study that was done in Dermatology Department of Salah-Aldin General Hospital in Tikrit city in a period from October 2019 till June 2020. A sample of 50 patients were included and complete information were recorded including history , clinical examination and investigation ( scrapping test with Potassium hydroxide (KOH) mount and fungal culture) were taken from all lesions of all participants.

Results: 30 (60%) of patients with unilateral hand eczema had negative KOH mount and fungal culture all of which didn’t show response to 4-5 weeks of topical and systemic antifungal. However, they respond excellently to topical steroid. While, 13(26%) of cases had both KOH examination and fungal culture positive and all of which respond excellently to 4-5 weeks of systemic and topical antifungal. The rest 7(14 %) of cases had 3(6%) positive fungal culture with negative koh and 4(8%) positive koh with negative culture. Both groups were significantly different in residence, risk of animal contact, occupational risk and feet involvement. (p=0.008, p=0.003, p=0.01, 0.02) respectively. Gender, age, clinical feature and distribution of lesions duration, history of atopy and diabetes mellitus had no significant association. (P value = > 0.05)

Conclusion: This study proved that unilateral hand eczema is present and existent and not all unilateral hand scaly lesion are fungal as previously believed.