Dyshidrotic eczema (dyshidrosis/ pompholyx) is a rare skin condition characterized by small blisters which are filled with fluid developing on the palms and on the lateral sides of the fingers. Sometimes, this condition can also affect the soles of the feet. These blisters cause intense itching to the patient and they can last about three weeks after which they start to dry up resulting in scaly skin. The blisters of dyshidrotic eczema tend to recur and sometimes they can reappear before the previous/old blisters have completely resolved.
Treatment comprises of topical ointments and creams to apply on the affected skin. Oral corticosteroids can be prescribed in severe cases.
Causes of Dyshidrotic Eczema or Pompholyx
The cause of dyshidrotic eczema is not known. It can occur along with other similar skin disease, such as atopic dermatitis; or it can also be seen with allergic conditions, like hay fever. Patients suffering from nasal allergies can have seasonal eruptions on their skin.
Risk Factors for Dyshidrotic Eczema or Pompholyx
- Stress highly increases the risk of developing dyshidrotic eczema.
- Exposure to metals, such as cobalt, chromium and nickel can trigger Dyshidrotic Eczema or Pompholyx.
- Individuals who have sensitive skin are at a higher risk for having Dyshidrotic Eczema or Pompholyx.
- Patients who are already suffering from other skin conditions, such as atopic eczema, can develop Dyshidrotic Eczema or Pompholyx.
Signs & Symptoms of Dyshidrotic Eczema or Pompholyx
- The blisters commonly appear on the palms and on the lateral sides of the fingers.
- The soles of the feet can also be involved.
- The blisters are quite small in size and usually develop in clusters resembling tapioca.
- In severe Dyshidrotic Eczema or Pompholyx, the small blisters coalesce together and form larger blisters.
- Patient experiences intense itching and sometimes pain in the affected region.
- After the blisters dry, they flake off in about 3 weeks revealing a red and render skin underneath.
- Dyshidrotic Eczema or Pompholyx has tendency to recur quite regularly.
Investigations for Dyshidrotic Eczema or Pompholyx
Physical exam is sufficient for diagnosing Dyshidrotic Eczema or Pompholyx. There are no specific tests to confirm the diagnosis of dyshidrotic eczema; however, tests can be done to exclude other skin conditions with similar symptoms. For example, scraping from the skin can be taken and tested to look for fungus which causes athlete's foot.
Treatment for Dyshidrotic Eczema or Pompholyx
Treatment Depends On The Severity Of Dyshidrotic Eczema or Pompholyx And Includes:
- Topical corticosteroid creams and ointments of high-potency help in resolution of the blisters. After application, the affected region can be wrapped in plastic to increase the medicine absorption.
- Application of moist compresses also helps with the absorption of corticosteroid cream/ointment.
- For severe cases, corticosteroid pills like prednisone can be prescribed; however, their long-term use has some serious side effects.
- Phototherapy where the affected region is exposed to UV light can also help.
- Topical immunomodulators, such as pimecrolimus and tacrolimus, is also beneficial and without the harmful side effects of corticosteroids. However, these medicines have the tendency to increase the risk of skin infections.
- Some physicians recommend botulinum toxin injections for severe cases of dyshidrotic eczema. However, this is quite a new treatment and is not such widely used.
Home Remedies & Prevention for Dyshidrotic Eczema or Pompholyx
- Application of wet and cool compresses to the affected region can help in alleviating the itching.
- OTC antihistamines such as Benadryl, Alavert and Claritin help in relieving itching.
- The affected areas can be soaked in witch hazel to help promote the healing process.
- Stress can aggravate itching. So, it is highly recommended that the patient reduce his/her stress levels.
- Patient should try to avoid exposure to metals like nickel and chromium to prevent dyshidrotic eczema.