Dyshidrosis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Dyshidrosis
Dyshidrosis on the fingers
Synonyms	Pompholyx, dyshidrotic eczema, vesicular eczema
Pronounce	N/A
Specialty	Dermatology
Symptoms	Itchy blisters on palms, soles, and fingers
Complications	N/A
Onset	Young adulthood
Duration	Weeks to months
Types	N/A
Causes	Unknown, possibly allergies, stress, or sweating
Risks	Atopic dermatitis, hay fever, asthma
Diagnosis	Clinical examination
Differential diagnosis	Contact dermatitis, scabies, psoriasis
Prevention	N/A
Treatment	Moisturizers, steroid creams, phototherapy
Medication	N/A
Prognosis	N/A
Frequency	~5-20 per 10,000 people per year
Deaths	N/A

Dyshidrosis, also known as dyshidrotic eczema or pompholyx, is a type of dermatitis characterized by the appearance of small, itchy blisters on the palms of the hands and soles of the feet. These blisters, generally one to two millimeters in size, heal over the course of three weeks, but may frequently recur. Although redness is not typically present, repeated bouts can result in skin thickening and fissures.

Symptoms and Diagnosis

The primary symptom of dyshidrosis is the formation of blisters filled with fluid, accompanied by intense itching, which may become painful if left untreated. Over time, these blisters may become larger, merge together, and eventually dry out, leading to cracked and peeling skin. Skin thickening, or hyperkeratosis, may occur as a result of chronic, repeated episodes. Diagnosis is generally made based on the appearance of the skin and reported symptoms. There are no specific lab tests to confirm dyshidrosis, but physicians may perform patch testing or skin biopsies if necessary to rule out other possible conditions, such as fungal infections or psoriasis.

Causes and Triggers

The exact cause of dyshidrosis is unknown, but it is thought to be related to allergic reactions and the body's immune response. Certain factors can trigger or worsen the condition, including:

• Stress
• Exposure to certain metals, such as nickel and cobalt
• Fungal infections
• Skin exposure to water or moist environments

Treatment

The primary goal of treatment for dyshidrosis is to alleviate itching and prevent new blisters from forming. Treatment options include:

• Topical steroids to reduce inflammation
• Antihistamines to relieve itching
• Immunosuppressant drugs, such as cyclosporine or methotrexate, for severe cases
• Ultraviolet light therapy (phototherapy)
• Emollients or moisturizers to help keep skin hydrated
• Lifestyle modifications, such as avoiding known triggers and keeping the skin clean and dry, can also help manage symptoms and reduce the frequency of flare-ups.

Gallery

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  Dyshidrotic dermatitis on hands, late stage

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  Dyshidrosis

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  Palmar dyshidrosis, peeling stage

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  Dyshidrosis, late stage

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  Rim of scale on plantar surface of thumb

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