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Vesicular hand dermatitis

doi: 10.1097/01.NPR.0000547541.89972.b1
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INSTRUCTIONS Vesicular hand dermatitis

TEST INSTRUCTIONS

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PROVIDER ACCREDITATION

Lippincott Professional Development will award 1.0 contact hour for this continuing nursing education activity.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.0 contact hour. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

This activity has been assigned 0.5 pharmacology credit.

Vesicular hand dermatitis

Purpose: To provide information on the diagnosis and treatment of vesicular hand dermatitis. Learning Objectives/Outcomes: After completing this continuing-education activity, you should be able to: 1. Review clinical presentation and differential diagnosis of vesicular hand dermatitis. 2. Identify the treatment and management of vesicular hand dermatitis.

  1. Vesicular hand dermatitis is associated with all of the following except
    1. excessive use of greasy ointments.
    2. exposure to irritants.
    3. frequent hand washing.
  2. Which statement best describes vesicular hand dermatitis?
    1. Itchy fluid-filled vesicles on the tops of the hands and feet.
    2. Painful fluid-filled vesicles on the hands and arms.
    3. Tiny, symmetrical, fluid-filled vesicles localized on the sides of fingers and palms of hands.
  3. The peeling of skin occurs
    1. in chronic conditions and is associated with infection.
    2. prior to the eruption of vesicles.
    3. usually 2 to 4 weeks after the vesicles appear.
  4. MJ is a data entry clerk who works from home and suffers frequent flare-ups. Her expressed concerns with job security are related to
    1. emotional distress and embarrassment.
    2. impaired manual dexterity.
    3. out-of-pocket expense for a dermatologist.
  5. Which is the most important clue to a differential diagnosis for vesicular hand dermatitis?
    1. clinical pattern of the lesions
    2. family history of dermatitis
    3. personal history of smoking and alcohol use
  6. When inquiring about the patient's occupation, all the following are triggers for vesicular hand dermatitis except
    1. the number of hours spent on the job.
    2. the frequency of hand washing.
    3. the use of occlusive gloves to perform work duties.
  7. In the patient with chronic vesicular hand dermatitis, which diagnostic test is indicated if a secondary infection is suspected?
    1. bacterial swab
    2. complete blood cell count
    3. patch testing
  8. Allergic contact dermatitis may present with
    1. a raised, ring-shaped rash with red borders.
    2. pustules and scaly plaques.
    3. blisters, erythema, and scaling.
  9. The differentiating characteristic of palmoplantar psoriasis from vesicular hand dermatitis is the presence of
    1. pustules.
    2. red borders.
    3. scaly and peeling skin.
  10. Tinea manuum is best described as a
    1. bacterial infection that results from chronic vesicular hand dermatitis.
    2. fungal infection that presents with severe itching and a raised rash with red borders.
    3. vesicular dermatitis that occurs on the toes and feet.
  11. When managing vesicular hand dermatitis, treatment is directed at
    1. applying corticosteroid creams to prevent secondary infections.
    2. avoiding emollients and alcohol-based hand sanitizers.
    3. maintaining skin integrity with emollients.
  12. Which statement reflects best practice with emollient and topical corticosteroid use?
    1. Apply the corticosteroid cream and emollient together.
    2. Emollients are not indicated for skin integrity when a corticosteroid cream is prescribed.
    3. Emollients should be applied and absorbed into the skin prior to using topical corticosteroids.
  13. Which Class I topical corticosteroid is recommended for vesicular hand dermatitis?
    1. Fluocinonide 0.05%
    2. Triamcinolone acetonide 0.025%
    3. Clobetasol propionate 0.05%
  14. Treatment with a topical corticosteroid should be
    1. daily for up to 3 weeks.
    2. twice daily for up to 2 weeks.
    3. twice daily for 2 weeks then daily for 1 week.
  15. Using the fingertip method to apply a topical corticosteroid to the whole left hand, how many fingertip units should be applied?
    1. half
    2. one
    3. two
  16. Which statement is correct when considering antihistamine use for severe itching associated with vesicular hand dermatitis?
    1. Antihistamines shorten the course of dermatitis.
    2. Diphenhydramine does not cause drowsiness.
    3. Hydroxyzine is more effective than diphenhydramine.
  17. All of the following practices help maintain skin integrity except
    1. using an alcohol-based hand sanitizer.
    2. washing hands often when exposed to irritants.
    3. wearing cotton liners under vinyl gloves at work.
  18. Stress and smoking may increase
    1. bacterial secondary infection.
    2. size of the vesicles.
    3. incidence of flare-ups.
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