Diseases

Dyshidrotic Eczema – Causes, Symptoms & Treatment

Dyshidrotic eczema

Dyshidrotic eczema is a skin condition characterized by blisters on the palms, sides of the fingers, and soles of the feet. Its exact causes have not yet been fully elucidated, but there is a connection with medications and other substances, fungi, bacteria, viruses and psychological factors. The therapy focuses mainly on individual triggers and the treatment of the skin change.

What is dyshidrotic eczema?

Dyshidrotic eczema is a dermatological condition that causes small blisters to develop on the palms of the hands and soles of the feet. The clinical picture represents a specific form of eczema and as such belongs to the inflammatory skin diseases. Other names for dyshidrotic eczema are dyshidrosis or dyshidrosis , pompholyx or dyshidrotic eczema .

Two variants can occur with this skin disease: In the case of dyshidrosis lamellosa sicca, it only shows up as a weak change in the skin. In the short course of the acute phase, the vesicles dry out on their own, leaving behind their empty shell. This also dries out and gradually detaches from the skin in scales as new skin cells grow back . In the Cheiropompholyx or Podopompholyx variant, on the other hand, the vesicles are larger, partially merging and forming a larger target for infections.

causes

Researchers originally thought that the cause of dyshidrotic eczema was a malfunction in the sweat glands. The name of the disease, which means “bad sweat”, goes back to this fallacy. Today, however, it is known that this cause is not true; the exact factors that cause dyshidrotic eczema are not known.

The specialist literature discusses, among other things, the connection between dyshidrotic eczema and various medications, other chemical substances, bacteria and fungi. Psychological factors such as stress may also play a role in the onset of the disease. People who suffer from a contact allergy or atopy are more likely to develop dyshidrotic eczema.

In these cases, however, the skin change must not be entirely due to one of the two skin diseases, but must be present independently of it; otherwise, despite the similar appearance, it is not a matter of dyshidrotic eczema but of a contact allergy or atopy. In this context, a good differential diagnosis is important.

Symptoms, Ailments and Signs

Itching often occurs in the affected areas of the skin and is typical of all types of eczema. In dyshidrotic eczema, small blisters form under the skin on the palms of the hands, sides of the fingers and soles of the feet, which are filled with fluid and can stretch the overlying tissue. The liquid inside is yellowish or colorless.

Reddening of the skin around the blisters is also one of the typical symptoms. With eczema that lasts longer, the skin may thicken, begin to flake, or form a leathery surface. As a result, the skin loses its elasticity, making it more prone to bleeding cracks.

These so-called rhagades usually heal without scarring. Because the skin on the hands and soles of the feet, where the blisters in dyshidrotic eczema usually appear, is constantly in motion, the healing process can be slow. The affected areas often tear again and again, especially without the use of ointments.

Diagnosis & History

The external appearance of the skin changes is usually sufficient for the diagnosis. Since allergic reactions can cause similar symptoms, an allergy test for contact allergies is often part of the diagnosis. In the patch or patch test, the most common allergens that are possible triggers are applied to the skin and covered with a large patch.

After 48 and 72 hours, sometimes also after 96 hours, the diagnostician checks whether there is any change in the treated skin. A positive reaction means an allergy is present. In addition to contact allergy, atopy is also considered in the differential diagnosis. It can cause atopic eczema, which is similar to dyshidrotic eczema.

As the skin disease progresses, the vesicles of dyshidrotic eczema may coalesce; medicine calls this process confluence. In some cases, dyshidrotic eczema is accompanied by an infection, for which viruses and fungi are the main causes. The pathogens can penetrate the tissue in particular via burst or scratched blisters. The large bladders in the Cheiropompholyx and Podopompholyx variants are particularly prone to this complication.

complications

The disease mainly affects the skin. Blisters form, which in most cases are also associated with itching. Often there is also increased sweating on the skin, which is uncomfortable for many patients.

The blisters can also burst, causing fluid to leak out. The itching tempts many sufferers to scratch, which usually only intensifies the itching. The quality of life decreases significantly as a result of the disease. Certain activities are also no longer possible for the patient, since contact with the skin would otherwise lead to pain.

The symptom is treated with the help of creams, ointments and medication and in most cases leads to success relatively quickly. There are no further complications. In the case of allergies, the patient must avoid the respective triggering substance so that the symptoms do not occur. As a rule, the disease can be narrowed down relatively well if attention is paid to a healthy diet. Life expectancy is not reduced.

When should you go to the doctor?

If unusual itching is suddenly noticed, a general practitioner should be consulted. At the latest when the characteristic blisters form under the skin, the dyshidrotic eczema must be clarified and treated. In the further course, redness and skin tears can occur, which should be observed first – the doctor must be informed in the event of bleeding or infections. People who suffer from atopy or a contact allergy are particularly likely to develop dyshidrotic eczema.

Likewise, people who regularly take certain medications or chemical substances. Psychological factors such as stress can also promote the skin disease. Anyone who belongs to these risk groups should consult a doctor if they experience the symptoms mentioned. The doctor will either be able to clarify the disease beyond a doubt or refer the patient to an allergist .

In any case, several visits to the doctor are required before dyshidrotic eczema can be diagnosed with certainty. If the eczema becomes inflamed, a dermatologist is ideally consulted immediately. In the event of major complications, the medical emergency service should be contacted.

Treatment & Therapy

Various ointments, creams and lotions are used for external treatment. They often contain glucocorticoids , a type of corticosteroid . The aim of the active substance is to inhibit the inflammatory reaction. Corresponding ointments are particularly suitable for shorter applications, as they can cause increased side effects if used regularly over weeks and months.

Drugs containing 9-cis-retinoic acid (alitretinoin) are a treatment option, even if glucocorticoid therapy is unsuccessful. Tannins may accelerate the drying out of the blisters on hands and feet, zinc ointment can also have an anti-inflammatory effect. Appropriate hygiene measures can help reduce the risk of complications arising from infections.

However, gloves and washing and disinfecting hands too often – even at work – are considered problematic. Which treatment option makes sense varies from person to person. A decisive factor is the specific cause of dyshidrotic eczema: If a causal treatment is possible, further therapeutic measures can take effect.

Outlook & Forecast

The prognosis of dyshidrotic eczema is good. Although the exact cause is not yet complete, the individual triggers can be treated and treated with current medical options. In addition, there are various risk factors that promote the occurrence. If the patient manages to avoid these, he favors the further course. As soon as the active ingredients of prescribed medicines develop their anti-inflammatory effect, the symptoms are relieved.

The treatment plan is drawn up according to the individual complaints of the patient. In many cases, the patient can actively influence the improvement of his symptoms through his hygiene and cleanliness behavior. The prospect of relieving the lesions worsens once the itching of the rash is given in to.

In these cases, the patient is threatened with the penetration of other pathogens into the organism. In severe cases, this can lead to blood poisoning . The situation is life-threatening for the person concerned.

If psychosomatic reasons lead to the outbreak of the disease, the healing process can take several years. In the case of seasonal causes, the patient experiences periods of complete freedom from symptoms. A return of the eczema is lifelong and possible at any time. The affected person should avoid stress and coordinate the use of skin care products with the doctor so that no ingredients are used that lead to an increase in the symptoms.

prevention

In the case of dyshidrotic eczema, prevention can focus on typical triggers: patients can avoid substances that act as triggers for them individually. Patients can also prevent psychological factors such as stress, for example with relaxation techniques and stress management training.

aftercare

In the case of this disease, the person affected is primarily dependent on direct treatment by a doctor. The measures or options for aftercare are usually very limited, so that the focus is on early detection and continued treatment by a doctor. Self-healing is also not possible, so that the affected person is always dependent on a visit to a doctor.

With this disease, the person affected should avoid infections as much as possible. A high standard of hygiene must be observed, and the affected person should wash frequently. In the event of an infection, the first thing you should do is see a doctor to treat it. Furthermore, most patients are dependent on taking medication.

The person concerned should always ensure that they are taken regularly and that the dosage is correct in order to relieve the symptoms properly and permanently. If the medication causes severe side effects, a doctor should also be consulted before the medication is discontinued. In most cases, this disease does not reduce the life expectancy of the affected person.

You can do that yourself

In dyshidrotic eczema, small blisters form on the hands and feet. The cause of this disorder was previously thought to be a malfunction of the sweat glands, but this is not the case. The trigger for the disease is considered unclear, but a connection with medication, contact allergies, excessive hygiene and mental stress is suspected. Those affected should always consult a doctor so that an allergy can be ruled out and the symptoms can be treated professionally.

Due to the mostly unknown causes, an important contribution to self-help is to keep a diary to check whether there is a statistical connection between certain activities and acute flare-ups of the disease. If new blisters form a few days after stressful situations , for example an exam or a dispute with the supervisor or family members, psychological factors should be considered as triggers. Those affected can then learn relaxation techniques to better manage negative stress.

A food diary can also be used to determine whether a food allergy could be a contributing factor. In these cases, the person concerned may have to change their eating habits.

The blisters should never be scratched open. Antihistamines in drop form, which are available over-the-counter in pharmacies , help against severe itching . In many cases, the healing process can also be accelerated by applying a thick layer of zinc ointment to the affected areas in the evening. Cotton gloves or cotton socks should be worn so that the ointment can take effect overnight.

Lisa Newlon
 | Website

Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.