a) atopic hand dermatitis _ _ _ _ _ _ _ _ _ _ Correct ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

b) allergic contact dermatitis _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

c) necrobiosis lipoidica diabeticorum _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

d) irritant dermatitis _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

e) all of the above _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

Answer and Commentary _ _ _ _ _ _ _ _ _ _ Atopic dermatitis of childhood often clears around puberty to re-emerge in the late teenage years as a chronic hand dermatitis. This hand dermatitis usually affects the fingers and may extend onto the palms. Exposure to irritants, including regular exposure to soap and water, will aggravate the dermatitis. Atopics may in addition also develop an allergic contact dermatitis. Patch testing for possible allergic contact dermatitis is necessary in the work-up of all patients with hand dermatitis including atopics. ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯