Common inflammatory disorders such as psoriasis, atopic dermatitis and contact dermatitis often involve the hands and feet, but the different morphology on palms and soles can make diagnosis challenging, according to a Focus Session at the American Academy of Dermatology's annual scientific sessions in Washington, D.C.
Session director Dr. Robert Bissonnette of Montreal provided two take-away messages from the forum:
1. Clinicians should aim to perform a differential diagnosis when they see a patient with chronic hand inflammatory hand and foot diseases. The effort should be directed toward the differential Dx, rather than trying to determine if the condition looks more like psoriasis or dermatitis in order to prescribe a treatment.
2. As several presenters mentioned during the session, think about sending the patient for patch testing. "I think all eczema patients should be referred for patch testing, and some psoriasis patients and some with other inflammatory diseases of the hands and feet as well," Dr. Bissonnette told DERM.city
"Patch testing is something we don't do enough of," said Dr. Bissonette.