Are itchy, thick patches on both hands a sign of eczema?

Question

Hello doctor,

My husband, aged 35, has developed thick, dark patches with severe itching on both hands over the past three months. He works in a factory and washes his hands frequently. The skin peels and sometimes bleeds due to scratching. Please let us know the following:

Could this be hand eczema related to chemical exposure?
How can we differentiate between eczema and a fungal infection?
Should he take leave from work to prevent further irritation?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query.

From what you described about your husband’s symptoms, the condition does sound consistent with hand eczema (a group of skin conditions that cause inflammation, itching, dryness, and irritation of the skin), especially considering his factory work and frequent hand washing.

It could very likely be hand eczema related to chemical exposure. People who work in factories often develop irritant contact dermatitis because of repeated exposure to chemicals, detergents, solvents, or oils. Frequent hand washing, sanitizers, friction, and moisture from gloves or sweat can also irritate the skin and worsen the condition.

Eczema and fungal infections can sometimes look similar, but there are a few differences. Hand eczema usually causes intense itching, thick and rough skin, cracks, and gradual darkening of the skin.

It often affects both hands and may improve with moisturizers and steroid creams. A fungal infection, on the other hand, often affects one hand more than the other, may show clear scaly borders, and can involve the spaces between the fingers. It may also worsen if steroid creams are used.

To confirm the diagnosis, a dermatologist may perform a simple test called a KOH examination (potassium hydroxide test) or fungal scraping. It is a simple lab test where doctors check a small skin sample under a microscope to see if a fungal infection is present. This helps rule out a fungal infection before starting steroid treatment.

Taking temporary leave or modifying work duties can help if the skin is cracked, bleeding, or worsening with workplace exposure. If leave is not possible, protective steps are very important.

Your husband should try to

Avoid direct contact with chemicals and irritants.
Use nitrile gloves instead of latex.
And wear cotton gloves inside if possible to reduce sweat and friction.
Hand washing should be minimized when possible, and harsh soaps should be avoided.
Using soap-free cleansers and applying thick moisturizers frequently, especially after washing hands, can help protect the skin.

Once a fungal infection is ruled out, treatment usually includes a short course of topical steroid creams to reduce inflammation and regular use of moisturizers. Applying a thick moisturizer at night and wearing cotton gloves while sleeping can also help the skin heal better.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.