Dyshidrotic eczema

Synonym(s)

Dyshidrosis; pompholyx; vesicular pal-moplantar eczema; vesicular eczema of palms and soles

Dyshidrotic eczema. Multiple vesicles on the hands, with concentration along the sides of the digits

Definition

Recurrent or chronic relapsing form of vesicular palmoplantar dermatitis

Pathogenesis

Occurring commonly in atopic individuals; associated with stress, infection, exogenous contactants, climate changes

Clinical manifestation

Symmetric crops of clear vesicles and/or bullae on the palms and lateral aspects of fingers and feet; vesicles deep seated, with a tapioca-like appearance, and sometimes becoming confluent to form bullae; may develop crusting, scaling, and fissuring after persistent scratching

Differential diagnosis

Contact dermatitis; vesicular tinea pedis; tinea manus; palmoplantar pustular psoriasis; autosensitization reaction (id reaction)

Therapy

Corticosteroid, topical, high potency*; severe flare: prednisone; triamcinolone 4080 mg IM as single dose. Chronic persistent disease: azathioprine; local photochemotherapy; disulfiram 250500 mg PO per day in nickel-sensitive patients; aluminium acetate 5% solution soaks

References

Landow K (1998) Hand dermatitis. The perennial scourge. Postgraduate Medicine 103(1):141-142, 145-148, 151-152

196 Dyskeratoma, warty

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