Hand eczema in a 22-year-old woman with piercings

William Abramovits, MD, and Lisa C. Stevenson, BA

In mid 2002, we examined a 22-year-old waitress who complained of a 5- to 6-month history of painful, pruritic lesions on her hands, arms, and legs. The itch often disturbed her sleep, and her quality of life was diminished by physical discomfort and feelings of embarrassment. Lesions on both palms showed minimal vesiculation, moderate papulation and scaling, moderate to severe erythema, and severe fissuring and lichenification. Lesions on her arms and legs were less severe, showing only slight erythema and papulation.