Histologic examination of the biopsy specimen revealed psoriasiform acanthosis with thick parakeratosis. A heavy lymphohistiocytic infiltrate in the upper dermis was noted, along with an interface dermatitis with occasional colloid bodies. Lymphocyte exocytosis was seen.
Our patient experienced little benefit from treatment with a variety of topical agents, including 0.05% clobetasol propionate and propylene glycol. However, her skin, joint, and muscle problems dramatically improved after therapy with systemic prednisolone (30 mg/d) and azathioprine (100 mg twice daily) was initiated.
Eczematous Changes on the Hands—Diagnosis. Arch Dermatol. 2005;141(6):779-784. doi:10.1001/archderm.141.6.779-g