Figure 2. Eczematous skin changes on the hand of a 19-year-old Asian male, with a personal history of atopic dermatitis.

The patient initiated preventive hand washing measures two months ago, without hydrating the hands afterward and developed severe skin dryness, fissuring (white arrow), and scaling.  Also the irritant-induced changes have progressed to hyperkeratosis and acanthosis (black arrows), highlighting the cumulative exposure.