Dyshidrosis

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Alternative names
Dyshidrotic eczema; Pompholyx

Definition
Dyshidrotic eczema is a condition in which small blisters that cause intense itching develop on the hands and feet.

Causes, incidence, and risk factors
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. The vesicles produce intense itching. Scratching leads to skin changes with thickening. Scratching may also lead to secondary infections.

Symptoms

• Intense itching at the site of the blistering.
  
• Cracks or fissures on the fingers or toes.
  
• Pain may occur with larger blisters.

Signs and tests

Your physician may often diagnose dyshidrotic eczema based upon the appearance of your skin. Occasionally, a skin biopsy or skin scraping may be needed to rule out other causes.

Treatment

• Moisturizers
  
• Strong topical steroids
  
• Avoid scratching
  
• Oral anti-pruritics such as Atarax or Benadryl may alleviate itching

Expectations (prognosis)
Dyshidrotic eczema normally resolves without problems. Uninhibited scratching and skin trauma may lead to thick, irritated skin which is more difficult to treat and has a longer healing time.

Complications

• Secondary bacterial infection
  
• Pain and itching which limits the use of the hands

Calling your health care provider
Signs or symptoms of infection are present (tenderness, redness, warmth, or fever), or your rash does not clear with simple home therapy.

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