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A pruritic vesicular, pustular or squamous eruption confined to the lateral aspect of fingers or toes corresponds to the overall pattern of dysidrosis. Such a clinical pattern is defined by its peculiar topography. It is encountered in diseases resulting from various etiologies. Thus, conceptually, dysidrosis is a common clinical aspect shared by diverse disorders related to different etiologies and pathomechanisms. The dermatopathological assessment and the patch test procedure shed some light on this nosological diversity. Allergic contact dermatitis, irritation dermatitis, mycids, alterations of acrosyringia, and drug or food reactions are eventually involved in this process. However, most cases of dysidrotic dermatoses do not disclose their origins and they remain idiopathic.

A 35-year-old woman suffering from Crohn's disease for 3 years developed painful erythematous nodular lesions predominantly on the dorsa of her hands and feet, as well as on her elbows and wrists. The clinical features and histopathological picture of leukocytoclastic vasculitis were both highly suggestive of erythema elevatum diutinum. No improvement of the skin lesions was observed during treatment with high doses of oral steroids. In contrast, treatment with dapsone resulted in a marked reduction of skin lesions. During a new attack of her Crohn's disease the erythema elevatum diutinum lesions flared again. The parallel clinical course of erythema elevatum diutinum and Crohn's disease, as well as the detection of immune complexes and neutrophilic granulocytes in lesions of both diseases, strongly suggest a common etiology. This hypothesis is discussed in context with this case and the recent literature.

Knowledge of the relationship between a history of atopic dermatitis and nickel sensitivity as risk factors for hand eczema is limited. Our objective was to study the relative importance of atopic manifestations and nickel sensitivity as risk factors for hand eczema in women. From women referred for patch testing with a dental series, 100 consecutive nickel-positive and 95 nickel-negative patients were studied. A history of atopic manifestations and a history of 5 symptoms of hand eczema, i.e., dry erythemas, maculopapules, vesicles, erosions and hyperkeratoses were recorded. A history of atopic dermatitis was found to increase the risk of the 5 symptoms of hand eczema and sick leave due to hand eczema highly significantly. Nickel sensitivity increased only the risk of vesicles and erosions. Xerosis increased the risk of dry erythemas and vesicles. We concluded that a history of atopic dermatitis was more important than nickel sensitivity as a risk factor for hand eczema in women.