What is dyshidrotic eczema


Dyshidrotic eczemaIndicationsDermatitis Dyshidrotic eczema is an itchy skin disease that manifests itself as blisters or blisters on the sides of the fingers, palms of the hands, or on the feet. The vesicles are filled with edema fluid and lie in the epidermis of the skin. Various factors are involved in its development. It is often caused by atopy, atopic dermatitis, or allergic contact dermatitis. However, a functional disorder of the eccrine sweat glands (dyshidrosis) is not involved. Topical glucocorticoids are used for the treatment.

Synonymous: pompholyx, dyshidrosis, dyshidrosis, vesicles on the fingers, water vesicles between the fingers, dyshidrotic hand eczema, dyshidrotic eczema

Symptoms

The so-called dyshidrotic eczema manifests itself in itchy, not reddened blisters or blisters (bullae), which can appear on the finger sides, on the palms of the hands and also on the feet. The rash is often bilateral and symmetrical.

The vesicles or blisters are filled with edema fluid ("water vesicles") and lie in the epidermis. They persist for about two to four weeks and can be accompanied by inflammation.

Dyshidrotic eczema can recur and also be chronic. The severity is different. In the event of severe complaints, professional and private activities can be restricted. Superinfections can occur as a complication.

The disease was described by Tilbury Fox in 1873. It is also known as pompholyx, especially when large bubbles are present. The name and the possible causes are discussed controversially (Storrs, 2007). It was also recommended that the name be renamed “Acute and recurrent vesicular hand dermatitis”.

causes

Various factors are known that can trigger or worsen the disease.

Many patients have an allergic disposition (atopy) and atopic dermatitis. Allergic contact dermatitis to various substances such as metals (nickel, chromium, cobalt, see → metal allergy), fragrances, personal care products, cosmetics and Peru balsam can also be a cause.

The term dyshidrosis (dyshidrotic) indicates a connection with sweating. This can make the dermatitis worse in some cases. However, there is no malfunction of the eccrine sweat glands!

Other possible factors:

  • Skin fungi: dermatophytes, candida
  • Emotional stress
  • Temperature changes
  • genetics
  • Smoke
  • Medicines, especially intravenous immunoglobulins (IVIg)
  • Small injuries
  • Irritants such as soaps and disinfectants
diagnosis

The diagnosis is made during medical treatment based on the patient's history, physical examination and an allergy test. Other skin diseases must be ruled out.

Non-drug treatment
  • Cold compresses
  • Avoiding the triggers (metals)
  • Treat your hands regularly with a light hand cream.
  • Use a mild soap
  • Modification of the risk factors
Medication

The anti-inflammatory and antiallergic topical glucocorticoids are approved for the treatment. In severe cases, oral therapy may also be indicated, for example with prednisone (cortisone tablets).

Topical calcineurin inhibitors such as tacrolimus and pimecrolimus, like the glucocorticoids, have anti-inflammatory and immunosuppressive properties. They are applied locally as an ointment or cream.

Local photochemotherapy with 8-methoxypsoralen or psoralen and long-wave UV-A light is mentioned in the literature.

The following drugs, among others, are available for self-medication:

see also

Metal allergy

literature
  • Medicinal product information (CH)
  • Colomb-Lippa D., Klingler A.M. Dyshidrosis. JAAPA, 2011, 24 (7), 54 Pubmed
  • Fox T. Dysidrosis: an undescribed eruption. BMJ, 1873, 2, 365-366
  • Guillet M.H. et al. A 3-year causative study of pompholyx in 120 patients. Arch dermatol. 2007, 143 (12), 1504-8 Pubmed
  • Kotan D., Erdem T., Acar B.A., Boluk A. Dyshidrotic eczema associated with the use of IVIg. BMJ Case Rep, 2013, 2013 Pubmed
  • Lee K.C., Ladizinski B. Dyshidrotic eczema following intravenous immunoglobulin treatment. CMAJ, 2013, 185 (11), E530 Pubmed
  • Lehucher-Michel M.P. et al. Dyshidrotic eczema and occupation: a descriptive study. Contact Dermatitis, 2000, 43 (4), 200-5 Pubmed
  • Dermatology textbooks
  • Mayo Clinic
  • Nishizawa A. Dyshidrotic Eczema and Its Relationship to Metal Allergy. Curr Probl Dermatol, 2016, 51, 80-5 Pubmed
  • Storrs F.J. Acute and recurrent vesicular hand dermatitis not pompholyx or dyshidrosis. Arch Dermatol, 2007, 143 (12), 1578-80 Pubmed
  • Veien N.K. Acute and recurrent vesicular hand dermatitis. Dermatol Clin, 2009, 27 (3), 337-53 Pubmed
author

Conflicts of Interest: None / Independent. The author has no relationships with the manufacturers and is not involved in the sale of the products mentioned.


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This article was last changed on April 28, 2021.
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