Eczema of the palmar and planar surfaces

Eczema of the palmar and planar surfaces, frequently accompanied with great thickening of the epidermis and with fissures, requires special treatment.

The thickened epidermis must be removed mechanically with knife, file, or sand-paper. After all that is possible has been removed in this way, a five per cent, solution of salicylic acid in flexible collodion should be applied. After several daily applications have been made, it will be found that still more of the epidermis may be easily removed. If infiltration be present, liquor potassae should be applied, taking care not to let it get into the fissures, if any be pre­sent. The fissures themselves should be dressed with gra­phite, and white precipitate or citric ointment applied to the entire diseased surface.

If, however, there be little infiltration or epidermic proliferation, tar or its equivalent is indicated if the surface is dry and scaling; while some of the less stimulating oint­ments should be applied if the surface be moist and exud­ing. At best, eczema of the hands, if already chronic, is an exceedingly obstinate affection, and one difficult to remove.