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Dyshidrotic Eczema - Definition, Causes, Symptoms and Treatment


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Dyshidrotic eczema is a form of eczema, in which tiny blisters of serum form just below the skin's surface. The most common factor in causing Dyshidrotic eczema is allergies and the situation becomes worse if the patient is a smoker or drinks a lot of coffee. Dyshidrotic eczema is also known as pompholyx. It is a recurrent disease or chronic relapsing form of vesicular palmoplantar dermatitis of unknown etiology. The etiology of dyshidrotic eczema is unresolved and believed to be multi-factorial. It is considered a reaction pattern caused by various endogenous conditions and exogenous factors. Dyshidrotic eczema tends to be a chronic condition that appears periodically throughout adulthood. Dyshidrotic eczema is a recurrent disease of the palmar and/ or plantar skin characterised by sudden eruptions of clear, mostly pruritic vesicles. Etiologic factors for dyshidrotic eczema include atopy, contact allergy, constant irritation, primary fungal infections and fungal id-reactions. An idiopathic form is also recognised. Smoking and excessive coffee consumption are believed to play an aggravating role.

Dyshidrotic eczema normally goes away without problems, but symptoms may later return. Although there is no known quick cure, dyshidrotic eczema does usually resolve with out problems. Dyshidrotic eczema may occur in both men and women. It is onset occurs usually before the age of 40. Individuals experiencing emotional stress may be more likely to develop flare-ups of this disease. The cause of dyshidrotic eczema is not known, but it occasionally appears to be seasonal. Small fluid filled blisters called vesicles appear on the hands and feet. They are most common along the edges of the fingers, toes, palms and soles. Excessive scratching can however lead to skin trauma causing thick irritated skin. This is often more difficult to treat and has a longer healing time than the actual condition. Excess scratching may lead to thick, irritated skin, which is more difficult to treat and takes longer to heal. If severe oral or intra muscular corticosteroids may be required along with antihistamines to decrease the itching. Antibiotics will be required when secondary infection occurs.

Causes of Dyshidrotic eczema

The cause of dyshidrotic eczema is not known, but it occasionally appears to be seasonal. Small fluid-filled blisters called vesicles appear on the hands and feet. They are most common along the edges of the fingers, toes, palms and soles. There may be a genetic component to the disorder. It has also been suggested that it could be caused by an allergic response to something in the environment. Experts suspect that nickel, balsam, and cobalt may cause the allergic response.

Common causes and risk factors of Dyshidrotic eczema:

  • Fungal infections.
  • The temperature changes.
  • Atopic dermatitis.
  • Some bacterial infections.
  • Increased humidity in the atmosphere.

Signs and Symptoms of Dyshidrotic eczema

Itching is the most common and annoying symptom of this condition. It usually is what causes a person to check his or her feet for problems. Scratching leads to skin changes and skin thickening. There may be cracks on the fingers or toes. When the condition is severe, small blisters may form, which sometimes contain pus. Sometimes the skin may look inflamed, dry, and scaly, or it may appear non-scaly.

Sign and symptoms may include the following :

  • Excessive sweating.
  • Cracks and gaps in the skin.
  • Extreme feeling of itching.
  • Tiny, deep-seated blisters.
  • Crusting skin lesions.

Treatment for Dyshidrotic eczema

Dyshidrotic eczema normally resolves without problems, but episodes may return. Uninhibited scratching and skin trauma may lead to thick, irritated skin which is more difficult to treat and has a longer healing time. Corticosteroid creams and ointments play an important role in the treatment of this disorder. Application of corticosteroid under plastic occlusion may increase their effectiveness. Antibiotics may be necessary if infection is present.

Treatment may include:

  • Dyshidrotic eczema is mostly  treated  with potent topical corticosteroids combined with the frequent application of moisturizers.
  • Chelating therapy may be introduce to remove itching.
  • In some severe cases of dyshidrotic eczema oral prednisolone can be used in short courses.
  • Immunosuppressants like Azathioprine, Methotrexate and even Cyclosporine can be used to get relief from pain and swelling.
  • Light therapy is also very effective in the treatment of dyshidrotic eczema.