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Skin layers
Skin layers


Dyshidrotic eczema

Definition:

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



Alternative Names:

Dyshidrosis; Pompholyx



Causes, incidence, and risk factors:

This blistering type of eczema is twice as common in women than men.

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



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 cause intense itching and scaly patches of skin that flake constantly or become red, cracked, and painful.

Scratching leads to skin changes and skin thickening. Large blisters may cause pain.



Signs and tests:

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

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

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



Treatment:
  • Anti-itch medicines taken by mouth (antihistamines)
  • Moisturizers
  • Strong steroid creams or ointments

Do not scratch the blisters. You should avoid frequent bathing, hand washing, and irritating substances, which can make itching worse.



Support Groups:



Expectations (prognosis):

There is no cure. Dyshidrotic eczema normally goes away without problems, but symptoms may return later. Excess scratching may lead to thick, irritated skin, which is more difficult to treat and takes longer to heal.



Complications:
  • Pain and itching that limits the use of the hands
  • Secondary bacterial infection


Calling your health care provider:

Call your doctor if you have:

  • Tenderness, redness, warmth, or fever, which may be signs of an infection
  • Any type of rash that does not go away with simple home treatments


Prevention:



References:

Morelli JG. Eczematous disorders. In: Behrman RE, ed. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: WB Saunders; 2007:chap 654.

Eczema and hand dermatitis. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 3.




Review Date: 12/11/2009
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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