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June 2005

Eczematous Changes on the Hands—Diagnosis

Author Affiliations
 

MICHAEL E.MINGMD

Arch Dermatol. 2005;141(6):779-784. doi:10.1001/archderm.141.6.779-g

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.

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