Case Study: Hand Dermatitis in an Endoscopy Nurse
Dennis Shusterman, MD, MPH
Division of Occupational and Environmental Medicine
University of California, San Francisco
A 35-year-old registered nurse was seen at the employee health clinic of a
university hospital for evaluation of hand dermatitis. She had a history of
atopic dermatitis since adolescence, but her hand symptoms (itching, peeling,
cracking, and redness) have only been significant for the last 4 years. During
her 8 years in nursing, the first 4 were spent in inpatient ward duties, and
the most recent 4 in an outpatient endoscopy service, where she wears gloves
approximately 6 hours a day. Physical examination reveals lichenified,
fissured, erythematous skin involving the palms, digits, and interdigital
spaces of both hands, with dorsal involvement of the digits on the right
greater than left. No vesicles or bullae are observed.
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