Hand Dermatitis: Review of Etiology, Diagnosis, and Treatment

Article Figures & Data

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Figure 1.
Irritant contact dermatitis on palms of a machinist.
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Figure 2.
Atopic hand dermatitis in a patient with a history of eczema.

Table 1.

Potency of Commonly Used Topical Corticosteroids²⁵

Group	Name
I (superpotent)	Betamethasone dipropionate ointment, cream 0.05%
	Clobestasol proprionate ointment, cream 0.05%
II	Fluocinonide ointment, cream/gel 0.05%
	Halcinonide, cream 0.1%
III	Betamethasone valerate ointment, 0.01%
	Fluticasone propionate ointment, 0.005%
IV (midstrength)	Fluocinolone acetonide cream, 0.2%
	Triamcinolone acetate ointment, 0.1%
V	Hydrocortisone valerate cream, 0.2%
VI (mild)	Desonide cream, 0.05%
VII (lowest potency)	Hydrocortisone, 0.5%, 1%, 2.5%
	Dexamethasone, cream 0.1%

Table 2.

SORT: Key Recommendations for Practice

Clinical Recommendation	Evidence Rating	References
Medium to high potency topical steroids are effective for initial treatment and exacerbations of mild to moderate hand dermatitis	B	16, 26
Petrolatum-based emollients are effective as adjuncts in the treatment of chronic hand dermatitis	B	16
The use of topical pimecrolimus is effective for treating chronic hand dermatitis	C	21, 22

A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series.