12-01-2010, 03:58 PM
You are evaluating a 33-year-old woman complaining
of dry hands. She is a cleaning lady who has had the
slow progression of erythema and edema, which has
evolved into fissuring and crusting on the palmar aspect
of the hand and wrist. She has been using gloves at work,
with minimal improvement, and has started using lubricating
creams. Her past medical history is significant only
for seasonal allergic rhinitis. The hands appear to be the
only areas involved (see Color Atlas, Figure XII-8). The
rest of her physical examination is normal. What is the
most appropriate treatment for this patient at this time?
A. Cephalexin 250 mg orally 4 times a day for 7–10 days
B. High-potency topical steroids
C. Hydroxyzine, 25 mg orally every 6 hours
D. Oral prednisone (1 mg/kg) tapered over 2–3 weeks
E. Topical retinoic acid
of dry hands. She is a cleaning lady who has had the
slow progression of erythema and edema, which has
evolved into fissuring and crusting on the palmar aspect
of the hand and wrist. She has been using gloves at work,
with minimal improvement, and has started using lubricating
creams. Her past medical history is significant only
for seasonal allergic rhinitis. The hands appear to be the
only areas involved (see Color Atlas, Figure XII-8). The
rest of her physical examination is normal. What is the
most appropriate treatment for this patient at this time?
A. Cephalexin 250 mg orally 4 times a day for 7–10 days
B. High-potency topical steroids
C. Hydroxyzine, 25 mg orally every 6 hours
D. Oral prednisone (1 mg/kg) tapered over 2–3 weeks
E. Topical retinoic acid