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Indian Journal of Dermatology, Venereology, Leprology, Vol. 70, No. 3, May-June, 2004, pp. 182-183 Letter To Editor Computer forearm Cyriac MJ, Nissar K Department of Dermatology and Venereology, Medical College, Kottayam, Kerala - 686008 Code Number: dv04059 Sir, A 22-year-old engineering student presented to our Outpatient Department with complaints of a persistent asymptomatic erythematous patch of 10 x 6 cm size on the anteromedial aspect of the right forearm extending from the hypothenar eminence to the distal third of the forearm. He was spending about 5-6 hours daily at the computer, including weekends, for the past 5 years. He had no other associated symptoms. On clinical examination he had a completely blanching erythematous patch with minimal follicular accentuation, without any excoriations, scaling or telangiectasia. [Figure - 1]. The patient was asked to simulate the use of the right hand on the desk top as if he was using the computer. The area of erythema on the forearm correlated exactly with the anatomical area that came into contact with the table top. There was no clinical evidence of urticaria, dermographism or contact allergic dermatitis. Skin changes induced by occupation are well known.[1] Over the past decade there are many reports of computer related dermatological, ophthalmological and musculoskeletal disorders.[2] Computer palms[3] and computer mouse fingers[4] have been described. Cases of prolonged computer use related upper limb musculoskeletal disorders (com RULM) are being recognized more frequently.[2] Such disorders are on the rise as more people use the computer for prolonged periods either for work or for recreational purposes. Our patient was using a computer daily for 5-6 hours for academic and leisure activities. The position of the forearm while using the mouse with the right hand causes repetitive friction, pressure and shear at the medial side of the distal forearm and hypothenar area. Moreover, our patient may also be exerting more pressure on the forearm while leaning forward to reduce back strain. A combination of long term pressure, moisture from sweating and friction from movement of the forearm, leads to engorgement of blood vessels at the friction site leading to erythema. Similar effects leading to persistent erythema at the tips of fingers and palms lead to mouse fingers and computer palms. To our knowledge there are no reports of vascular changes over the forearms. In our patient the delay in seeking medical advice was probably because of the absence of symptoms. REFERENCES
Copyright 2004 - Indian Journal of Dermatology, Venereology, Leprology The following images related to this document are available:Photo images[dv04059f1.jpg] |
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