Excessive scaling (hyperkeratosis), erythema, and painful fissures all characterize recurrent eczema of the fingertips. If vesicles are present, consider contact allergy.

Marked hyperkeratosis and painful fissuring of the palmar and lateral aspects of the fingers. Consider chronic friction, chronic irritant exposures, or psoriasis.

A hyperkeratotic finger with tender areas where plate-like scale has peeled away. It is typically painful, not pruritic. Irritants should be avoided. Systemic retinoids may help if emollients fail.