Hand dermatitis affects a significant portion of the population and can be caused by a variety of endogenous factors (ie, atopy) as well as occupational and environmental exposures. It is often a chronic problem with high costs to individuals, employers, and society. This review discusses subtypes of hand dermatitis based on their clinical features and pathogenesis. It also offers an approach to treatment.
Semin Cutan Med Surg 32:147-157 © 2013 Frontline Medical Communications
Targeted therapies continue to revolutionize the way we manage chronic inflammatory diseases in dermatology. In contrast to conventional immunosuppressive agents such as methotrexate, cyclosporine, and azathioprine, targeted therapies have the advantage of reducing inflammation to improve cutaneous disease while diminishing the concerns of cumulative end-organ toxicity.
In this review we focus on 2 of the noninfectious granulomatous dermatitides, granuloma annulare and interstitial granulomatous dermatitis (the remaining 6 will be discussed in Parts 2 and 3), with an overview of their clinical and histological presentations, differential diagnoses, and treatment options. The disorders we discuss are polymorphic in their clinical and histopathological presentations, follow chronic or undulating disease courses, and are typically recalcitrant to therapeutic interventions. Although the clinical history may be helpful, careful and thorough histopathological examination is required. Established treatment algorithms for these disorders are lacking, and no randomized, placebo-controlled studies have been published. Future investigations should focus on the evaluation of larger cohorts, not only to establish treatment recommendations in randomized, placebocontrolled trials, but also to reach a greater understanding of disease pathogenesis and clinical-pathological presentation.
Semin Cutan Med Surg 32:177-182 © 2013 Frontline Medical Communications