Dishidrotic eczema

Dishidrotic eczema (syn. dishidrotic dermatitis, dishidrotic dermatitis, pompholyx) is a chronic, non-contagious inflammation of the skin affecting the hands and feet. The disease is more common in women and in patients with atopic dermatitis or contact allergies.

Clinical signs:

• • characterised by an itchy rash with small subcutaneous vesicles
  • a burning sensation may be felt at the site of the rash
  • lesions on the skin of the hands, fingers, soles of the feet
  • superficial wounds, skin fraying during healing
  • the disease tends to recur

Risk factors:

• • genetic predisposition
  • increased sweating of the hands and feet
  • humid environment, frequent contact with chemicals (e.g. hand washing, washing dishes or floors)
  • sensitisation or allergy to environmental factors, most commonly nickel
  • reaction to medicines
  • emotional stress

Diagnostics

Diagnosis is based on characteristic clinical signs. If there is a suspicion that the rashes may be provoked by environmental substances or allergies, an allergen patch test is carried out and a doctor consultation with an allergist/clinical immunologist may be recommended.

If the diagnosis is in doubt, a biopsy of a skin graft may be performed.

Treatment

• • Avoidance of factors that provoke rashes is recommended (humid environment, allergic substances if found)
  • your doctor will assess the extent of the disease and choose topical preparations or a combination of oral medicines.
  • phototherapy treatments may be prescribed

Prophylaxis to prevent recurrence of rashes:

• • wearing cotton gloves and rubber gloves when working with wet hands
  • reducing profuse sweating (proper choice of footwear made of natural materials, cotton socks, antiperspirants, botulinum injections, etc.)
  • hand and foot creams to ensure good skin barrier properties