MKSAP: 34-year-old woman with very dry, painful hands

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old woman is evaluated for very dry, painful hands. She works in a daycare center and washes her hands 15 to 20 times daily, often for 2 to 3 minutes at a time. She has been applying lotion multiple times daily with no relief of the pain. She has a history of obsessive-compulsive disorder and takes no medications. On physical examination, vital signs are normal. She has xerosis on the dorsal aspect of her hands with lichenification, erythema, and fissuring. The remainder of the physical examination is unremarkable. In addition to decreasing the frequency of hand washing, which of the following is the most appropriate therapy? A: Petrolatum moisturizer B: Topical diphenhydramine C: Topical lidocaine gel D: Topical neomycin Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Dermatology Source Type: blogs