Dermatology case discussion: Contact dermatitis on a 42-year-old man

In this week's general dermatology case discussion, presented by Dr Dianne King, we look at a 42-year-old man presenting with irritant contact dermatitis.

Presentation

A 42-year-old healthcare worker presents with a six-month history of dry, cracked and persistently itchy skin on both hands. He has tried several over-the-counter moisturisers without sustained improvement. He works in a busy clinical environment and washes his hands and uses alcohol-based sanitiser repeatedly throughout each shift.

Examination

Examination shows chronic thickening of the skin across the dorsal hands and finger web spaces, with scaling, fissuring and excoriations. No vesicles are present and there is no involvement beyond the hands. The distribution and occupational history are consistent with irritant contact dermatitis resulting from repeated wet work and antiseptic exposure.

What would you do next?

What management plan would you recommend for this patient? Consider both treatment of the current flare and longer-term skin barrier care.

Share your approach in the comments below. Dr Dianne King’s management plan and the patient outcome will be added on Wednesday 23 September.

Interested to learn more?

This general dermatology case is presented by Dr Dianne King and featured in A Practical Guide to Common Skin Conditions in Primary Care, developed by HealthCert Education in partnership with CeraVe.

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