Skin rhagades (rhagadia manus et pedis) is a common winter skin disease among manual laborers, caused by various factors leading to dryness and cracking of the skin on the hands and feet.

bubble_chart Etiology

The metatarsus and the skin at the heel have a thicker stratum corneum and lack sebaceous glands, resulting in insufficient sebum for moisturizing and protection. In winter, factors such as low temperatures, dryness, wind exposure, reduced sweat gland secretion, along with irritation from acids, alkalis, and organic solvents, excessive friction or pulling, and certain chronic skin diseases (such as hyperkeratotic tinea manuum and pedis, contact dermatitis, chronic eczema, and ichthyosis) can lead to skin rhagades under the influence of physical, chemical, and biological factors.

bubble_chart Clinical Manifestations

This condition often occurs in the cold winter months. Initially, the skin on the fingertips, flexor side of the fingers, palms, heels, and outer edges of the feet becomes dry, rough, thick, and hard. Over time, fissures develop along the skin lines, typically 2–3 mm in length, though sometimes longer. Based on the depth of the fissures, the condition is generally classified into three grades: - **Grade I**: The skin is dry, and the fissures only reach the epidermis, causing no pain or bleeding. - **Grade II**: The skin is dry, and the fissures extend into the dermis, possibly causing mild pain but no bleeding. - **Grade III**: The skin is dry, and the fissures penetrate the dermis and subcutaneous tissue, often leading to pain and bleeding. In **Grade III rhagades**, the deeper fissures may sometimes result in secondary infections, leading to complications such as erysipelas, lymphangitis, and lymphadenitis. This condition is more common among manual laborers and farmers, primarily affecting adults and the elderly. The course of the disease is chronic, often resolving or improving with the arrival of warmer weather.

Treat the primary disease: Promptly treat skin diseases of the hands and feet, such as contact dermatitis, eczema, tinea, etc.

For local treatment, the following topical medications can be selected: 10-20% urea cream or ointment, 1% allantoin ointment, 0.05%-0.1% retinoic acid ointment, 3-5% salicylic acid ointment, Arnebia oil, or clam oil. The following plasters can also be used for sealing, changing every 2-3 days: ordinary zinc oxide adhesive plaster, fujining plaster, or yulie plaster. Before treatment, soak in hot water to soften the keratin, then thin it with a small knife before applying the medication for better results.

bubble_chart Prevention

Strengthen personal protection by enhancing labor protection and improving working conditions to avoid contact with irritants such as acids, alkalis, and organic solvents. Wash and dry hands promptly after work, and apply protective animal oil, Vaseline, or labor skin care cream, which is especially important in winter. Soak hands and feet in hot water daily during winter and keep them warm.