This too may fade away or persist in localized areas of the hands and face. Vesiculation, oozing, and crusting are common, and lesions are very pruritic, manifesting lichenified, reddened skin caused by excoriation. Again, it may fade away to recur during times of stress. Patients frequently develop irritant dermatitis, and most are particularly sensitive to formaldehyde and nickel. These patients are very susceptible to bacterial and viral infections and can develop severe, widespread pyoderma.
Treatment is directed at relieving pruritus, controlling infection, and promoting healing.
Topical corticosteroids and emollient creams can be used after the lesions are healed. A course of antistaphylococcal antibiotics for 2 weeks may be helpful in acute exacerbations. A short course of systemic corticosteroids may also be used. Avoidance is important, and a trial of environmental control, trial elimination of specific foods, and skin testing for food and inhalant allergens might be useful. Chronic dermatitis of the lower legs in people with chronic venous insufficiency.