Early 40s female with hx of hypertension. Works in a prison. | Figure 1

Early 40s female with hx of hypertension. Works in a prison. For over 6 months has this rash on her hands. Frequently uses sanitizer and latex based gloves while working. Otherwise healthy. Hands are itchy: red circle shows where I took biopsy. Did not do DIF but asked dermatopathologist if they recommend based on what they see.

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Update on 26 y/oM case. Was treated with Working Hands product (urea based cream). Patient sent this after 2 weeks but said it cleared up in about a week and a half. Does state his hands still get really dry easily but uses the cream religiously. Hasn't had anymore peeling since. Also has stayed away from any chemicals since. We know now that it was an oven cleaner/grease cutter that caused the peeling.

20yo hand vs heavy machinery at work. Patient intubated in the ER and taken to OR for amputation.

Any ideas what this could be? Pt. 53YM. Otherwise healthy. Chronic for a few years. Usually only on one hand but switches hands. Now on both hands. No labour work.

Work crush injury despite heavy leather gloves. 4mm distal phalange bone exposed. Sent to hand surgeon. Digital block worked wonders for the pain.

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