Pompholyx - Dyshidrotic Eczema

Dyshidrotic eczema is a fiercely itchy, deep-seated, blistering rash. It is seen most often on the palms of the hands, sides of the fingers, and soles of the feet.

What is going on in the body?

Dyshidrotic eczema was once thought to be due to trapping of sweat beneath thick skin of the palms and soles. Most healthcare providers now believe that it is caused by an inherited allergic response. The skin of the palms, sides of the fingers, and soles of the feet react to something in the environment by forming itchy blisters.

What are the causes and risks of the condition?

Dyshidrotic eczema can affect people of any age but appears to be more common in men between the ages of 20 and 50. There seems to be a genetic component to the disorder. It is probably caused by an allergic response to something in the environment. Experts suspect that nickel, balsam, and cobalt may cause the allergic response. Nickel is found in costume jewelry, while the other substances are used in manufacturing.

Risk factors that increase a person's risk for dyshidrotic eczema include:

Some experts believe that a fungal infection elsewhere in the body can cause dyshidrotic eczema on the hands. For example, someone with athlete's foot may develop eczema lesions on his or her hands.

The following factors have been linked to dyshidrotic eczema, but more research is needed to be sure:

What are the signs and symptoms of the condition?

Symptoms of dyshidrotic eczema include:

How is the condition diagnosed?

Diagnosis of dyshidrotic eczema begins with a medical history and physical exam. The healthcare provider may order blood tests to check for other causes of the rash.

What can be done to prevent the condition?

A person can help prevent dyshidrotic eczema by:

A person also can reduce the risk of this condition by managing stress and learning how to express his or her feelings.

What are the long-term effects of the condition?

Dyshidrotic eczema can cause a recurrent rash. The skin may heal completely between reoccurrences. At times, the skin may peel and crack. The person is at risk for an infection. In some cases, the eczema can be so severe that the person is unable to work or carry out normal activities.

What are the risks to others?

Dyshidrotic eczema is not contagious and poses no risk to others.

What are the treatments for the condition?

When an outbreak of dyshidrotic eczema occurs, treatment includes keeping skin dry and cool. Heat, sweating, and moisture can make symptoms worse. Treatment options include:

A diet low in nickel or cobalt may be considered. However, these diets are hard to follow, and their effectiveness has not been proven. Nickel levels are high in canned foods and foods cooked in nickel-plated utensils. Nickel is also found in a variety of fruits and vegetables, tea, cocoa, chocolate, and baking powder. Cobalt is found in a variety of fruits, vegetables, and spices. It is also high in cocoa, chocolate, and coffee.

What are the side effects of the treatments?

Long-term use of steroid creams can cause thinning of the skin. Antibiotics may cause rash, stomach upset, or other allergic reactions .

What happens after treatment for the condition?

Dyshidrotic eczema usually heals completely with treatment, but it may reoccur. Careful management may decrease the number of outbreaks. Biofeedback therapy for stress reduction has been successful in limiting outbreaks in some individuals.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Author:Lynn West, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:08/22/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:08/20/01

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