A patient recently came to me with cracked, peeling skin…

A patient recently came to me with cracked, peeling skin across her fingers and in the web spaces, with painful splits at the fingertips. Every time she touched soap, lemon, or chilli, it stung. She had been treating it as dry skin. Later, on a chemist's advice, she started using antifungal creams. It was neither. This was hand eczema caused by irritant contact dermatitis, something I commonly see in people whose hands are constantly exposed to water, detergents, cleaning products, and frequent washing. Every wash strips away