skip to main content

Pompholyx eczema — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral dermatology & dermatology in primary health carePompholyx eczemaSCE Dermatology

A nurse develops recurrent intensely pruritic deep-seated vesicles along the sides of both fingers and palms. Potent topical corticosteroid settles each flare, but relapses occur after glove use and hand cleansing. Which investigation is most useful for identifying a remediable driver?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Patch testing for occupational contact allergens after reviewing glove and cleansing exposures

Explanation lettering: E = shown as A · A = shown as D · D = shown as E

D is correct. The morphology is pompholyx, but recurrent occupational hand disease may be triggered or perpetuated by allergic contact dermatitis, including rubber accelerators, preservatives or cleansing-product allergens. Exposure history and patch testing can identify an avoidable driver. Pemphigoid serology is reserved for a compatible older or atypical blistering phenotype, capillaroscopy addresses connective-tissue vasculopathy, herpes is usually painful and grouped rather than symmetrically deep-seated and pruritic, and porphyria cutanea tarda causes fragile dorsal hands rather than palmoplantar vesicles. Mycology should also be considered when disease is unilateral or associated with tinea pedis.

Reference: DermNet dyshidrotic eczema review: https://dermnetnz.org/topics/dyshidrotic-eczema