Resolution of Dyshidrotic Dermatitis of the Hand After Treatment With Continuous Positive Airway Pressure for Obstructive Sleep Apnea

Abul Matin, MD, Donald L. Bliwise, PhD, James J. Wellman, MD, Heta Ann Ewing, Pam Rasmuson

Disclosures

South Med J. 2002;95(2) 

In This Article

Abstract and Introduction

Eczema of the palm and obstructive sleep apnea (OSA) are common disorders. Proinflammatory cytokines and cell adhesion molecules are elevated in both of these disorders. We describe an unusual patient with OSA who had recurrent free remission of dermatitis after treatment with continuous positive airway pressure. We speculate that the resolution of the patient's skin condition may reflect the effects of increased tissue oxygenation during sleep, reduced sleep fragmentation, and/or a reduction in sympathetic tone associated with successful sleep apnea treatment.

Nocturnal hypoxemia is a well-recognized phenomenon in severe obstructive sleep apnea (OSA). Tissue hypoxia has been shown to induce proinflammatory cytokines, adhesion molecules, and tissue inflammation,[1] and sleep apnea may be characterized by elevated cytokines.[2] Dyshidrotic dermatitis is a common form of eczema of the palms and soles. It is of obscure etiology,[3] but like hypoxia, it may also involve cytokines and cell adhesion molecules for induction and maintenance of skin inflammation.[4,5] Continuous positive airway pressure (CPAP) reduces the nocturnal hypoxemia of OSA and could conceivably play a role in reduction of inflammation by reducing circulating cytokines and cell adhesion molecules.

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