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dyshidrotic eczema

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Dyshidrotic eczema

Alternative Names
dyshidrosis, pomphylx

Dyshidrotic eczema is a fiercely itchy, deep-seated, blistering rash on the palms of the hands, sides of 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 doctors 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. This condition may also be caused by stress.

What are the signs and symptoms of the condition?
Symptoms of dyshidrotic eczema include:
  • tiny, deep-seated blisters, usually appearing on the sides and tips of the fingers, toes, palms of the hands, and soles of the feet
  • itching
  • weeping and crusting skin lesions
  • cracks and fissures in the skin
  • pain and swelling at the rash site
  • excessive sweating
Symptoms may get worse when exposed to heat, moisture, soap, or other irritating chemicals.

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 years old. It is probably caused by an allergic response to something in the environment, and is worsened by stress or anxiety. A person who has trouble expressing his or her feelings has a higher risk of developing this condition.

What can be done to prevent the condition?
A person can help prevent dyshidrotic eczema by:
  • taking good care of his or her skin
  • using heavy-duty gloves to protect the hands against chemicals
  • avoiding excessive sweating and excessive dryness
  • allowing feet to air frequently
  • wearing cotton socks
  • avoiding unnecessary exposure to soapy water
  • bathing with mild soap and lukewarm water and rinsing soap off well
A person also can reduce the risk of this condition by managing stress, and learning how to express his or her feelings.

How is the condition diagnosed?
To diagnose dyshidrotic eczema, the doctor will:
  • do a physical examination
  • closely examine the rash
  • take a person's medical history and history of stress
  • order blood tests to check for other causes of a rash
  • order a test of the blisters and skin to rule out an infection, such as a fungus
What are the long-term effects of the condition?
Long-term effects of dyshidrotic eczema include recurrent rash that improves with treatment, and discomfort from the rash with each episode. The skin may heal completely between reoccurrences. At times, depending on the severity of the condition, skin may peel and crack causing considerable discomfort, pain, and swelling.

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 may also involve use of topical corticosteroid creams to reduce itching and inflammation. If a secondary infection develops, oral or topical antibiotics may be prescribed.

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 may reoccur. Careful management and avoiding activities that increase symptoms may decrease the number of outbreaks.

How is the condition monitored?
Any new or worsening symptoms should be reported to the doctor.

Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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