Q. A patient presents with chronic pruritic, erythematous, scaly lesions with fissuring over both hands with a history of frequent hand washing. What is the diagnosis ?
A. Psoriasis.
B. Tinea manuum.
C. Irritant contact dermatitis.
D. Lichen planus.
✓ Answer: C. Irritant contact dermatitis.
- The clinical scenario describes chronic, itchy, red, scaly patches with fissuring on the hands, directly linked to frequent hand washing.
- This is a classic presentation of irritant contact dermatitis, one of the most common occupational/exposure-related skin conditions.
- Repeated water/soap/detergent exposure strips the skin's protective lipid barrier
- It is Common in healthcare workers, housewives, cleaners- anyone with frequent wet work.
∆ Clinical features- It Presents with dryness, erythema, scaling, and painful fissures, typically on the dorsum of hands and finger web spaces, Pruritus is common but usually milder than in allergic contact dermatitis. - No true "sensitization" (unlike allergic contact dermatitis)- it's a direct toxic/irritant effect on keratinocytes.
