Dyshidrosis/Dyshidrotic Eczema

Key Points
A form of eczema that affects hands and feet
Characterized initially by tiny blisters underneath the skin, which later forms a dry, scaly plaque
May Itch or burn
Cause is unknown

Dyshidrotic Eczema (also known as Dyshidrosis or Pompholyx) is a type of eczema that affects the hands and feet. It is characterized by very small blisters in the skin of the palms, feet, fingers, or toes. The blisters may Itch or burn intensely. Depending on the severity, there may be a little peeling or extreme scaling with blisters and cracks. It may even cause nail dystrophy (misshapen or partially destroyed nail plates). The disorder may come and go, and there is some indication that it reappears after stress or worry. Any irritation of the skin may also trigger an exacerbation.

Excessive soap and water as well as other detergents and solvents often exacerbate dyshidrotic eczema.

Differential Diagnosis (Other conditions with similar appearance)
Pustular Psoriasis
Primary fungal infection
Allergic or irritant contact Dermatitis
Recurrent focal palmar peeling

Diagnosis
Key Points
Visual inspection
Skin biopsy in some cases

A dermatologist can usually detect dyshidrotic eczema by inspecting the hands and feet, as the small blisters within the skin are obvious symptoms. However, skin scrapings or a biopsy may be performed to rule out other skin conditions or fungal infections.

Treatment
No cure
There are a variety of options to treat the symptoms, including topical and systemic medications depending on the severity of disease.

There is no cure for dyshidrotic eczema. Understanding the expectations is very important for patients with such a chronic disorder.

Treatment varies with the stage of the disease, although there are a number of methods for management. Topical steroids can reduce the inflammation and itching. Heavy moisturizing creams and ointments are required to replenish hydration and improve the broken skin barrier. Antibiotics can be given if there is an infection. Systemic steroids can offer a short-term treatment, but the side affects generally outweigh the benefits of long term therapy. Ultraviolet treatment may also control the symptoms.