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Dyshidrotic eczema

Dyshidrosis; Pompholyx

 

Dyshidrotic eczema is a condition in which small blisters develop on the hands and feet. The blisters are often itchy.

Eczema (atopic dermatitis) is a long-term (chronic) skin disorder that involves scaly and itchy rashes.

Causes

 

The cause is unknown. The condition seems to appear during certain times of the year.

You are more likely to develop dyshidrotic eczema when:

  • You are under stress
  • You have allergies, such as hay fever
  • Your hands are often in water or moist
  • You work with cement or do other work that exposes your hands to chromium, cobalt, or nickel

 

Symptoms

 

Small fluid-filled blisters called vesicles appear on the fingers, hands, and feet. They are most common along the edges of the fingers, toes, palms, and soles. These blisters can be very itchy. They also cause scaly patches of skin that flake or get red, cracked, and painful.

Scratching leads to skin changes and skin thickening. Large blisters may cause pain or can get infected.

 

Exams and Tests

 

Your doctor may be able to diagnose this condition by looking at your skin.

A skin biopsy may be needed to rule out other causes, such as a fungal infection or psoriasis.

If your doctor thinks the condition may be due to an allergic reaction, allergy testing (patch testing) may be done.

 

Treatment

 

SKIN CARE AT HOME

Keep the skin moist by lubricating or moisturizing the skin. Use ointments (such as petroleum jelly), creams, or lotions.

Moisturizers:

  • Should be free of alcohol, scents, dyes, fragrances, or other chemicals.
  • Work best when they're applied to skin that is wet or damp. After washing or bathing, pat the skin dry and then apply the moisturizer right away.
  • May be used at different times of the day. For the most part, you can apply these substances as often as you need to keep your skin soft. 

MEDICINES

Medicines that help relieve itching can be bought without a prescription.

  • Take an anti-itch medicine before bed if you scratch in your sleep.
  • Some antihistamines cause little or no sleepiness. These include fexofenadine (Allegra), loratadine (Claritin, Alavert), cetirizine (Zyrtec)
  • Others can make you sleepy, including diphenhydramine (Benadryl).

Your doctor may prescribe topical medicines. These are ointments or creams that are applied to the skin. Types include:

  • Corticosteroids, which calm swollen or inflamed skin
  • Immunomodulators, which help keep the immune system from reacting too strongly

Follow instructions on how to apply these medicines. Do not apply more than you're supposed to use.

If symptoms are severe, you may need other treatments, such as: 

  • Corticosteroid pills
  • Corticosteroid shots
  • Coal tar preparations
  • Phototherapy (ultraviolet light therapy) 

 

Outlook (Prognosis)

 

Dyshidrotic eczema usually goes away without problems, but symptoms may come back. Excess scratching may lead to thick, irritated skin. This makes the problem harder to treat.

 

When to Contact a Medical Professional

 

Call your health care provider if you have:

  • Signs of infection such as tenderness, redness, warmth, or fever
  • A rash that does not go away with simple home treatments

 

 

References

Burdick AE, Camach ID. Pompholyx. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 190.

James WD, Berger TG, Elston DM. Atopic dermatitis, eczema, and noninfectious immunodeficiency disorders. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 11th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 5.

 
  • Skin layers

    Skin layers - illustration

    The skin is the largest organ of the body. The skin and its derivatives (hair, nails, sweat and oil glands) make up the integumentary system. One of the main functions of the skin is protection. It protects the body from external factors such as bacteria, chemicals, and temperature. The skin contains secretions that can kill bacteria and the pigment melanin provides a chemical pigment defense against ultraviolet light that can damage skin cells. Another important function of the skin is body temperature regulation. When the skin is exposed to a cold temperature, the blood vessels in the dermis constrict. This allows the blood which is warm, to bypass the skin. The skin then becomes the temperature of the cold it is exposed to. Body heat is conserved since the blood vessels are not diverting heat to the skin anymore. Among its many functions the skin is an incredible organ always protecting the body from external agents.

    Skin layers

    illustration

    • Skin layers

      Skin layers - illustration

      The skin is the largest organ of the body. The skin and its derivatives (hair, nails, sweat and oil glands) make up the integumentary system. One of the main functions of the skin is protection. It protects the body from external factors such as bacteria, chemicals, and temperature. The skin contains secretions that can kill bacteria and the pigment melanin provides a chemical pigment defense against ultraviolet light that can damage skin cells. Another important function of the skin is body temperature regulation. When the skin is exposed to a cold temperature, the blood vessels in the dermis constrict. This allows the blood which is warm, to bypass the skin. The skin then becomes the temperature of the cold it is exposed to. Body heat is conserved since the blood vessels are not diverting heat to the skin anymore. Among its many functions the skin is an incredible organ always protecting the body from external agents.

      Skin layers

      illustration

    Self Care

     

      Tests for Dyshidrotic eczema

       

         

        Review Date: 7/23/2015

        Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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