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Dyshidrotic Dermatitis - Pompholyx

Intensely Itchy Rash on the Hands and Feet


Updated January 17, 2014

This condition goes by several different names - dyshidrotic eczema, dyshidrotic dermatitis, and pompholyx. The word dyshidrotic is used because it is felt that this condition is related to sweat glands, but this association has not been proven. The name pompholyx comes from the Greek word for bubble, which accurately describes this disorder.

Cause of Dyshidrotic Dermatitis
Nobody knows for sure what causes dyshidrotic dermatitis. Many people with atopic dermatitis also have dyshidrotic dermatitis, which may mean that dyshidrotic dermatitis is just a form of atopic dermatitis on the hands and feet. Emotional stress can make dyshidrotic dermatitis worse, but does not cause it. Ingestion of allergens such as chromate, neomycin, quinoline, or nickel may cause some cases.

Appearance of Dyshidrotic Dermatitis
The rash of dyshidrotic dermatitis occurs on the hands and feet. The majority of cases involve the palms and sides of the fingers, but the soles of the feet can also be involved. The rash looks like crops of clear, deep-seated, tapioca-like vesicles and is very itchy. The vesicles resolve in 3 to 4 weeks and are replaced by 1- to 3-mm rings of scale.

Treatment of Dyshidrotic Dermatitis
Most attacks resolve spontaneously within 1-3 weeks, but since the rash can be intensely itchy, the following medications may be used to speed healing or control the itching:

  • Aluminum subacetate, or Burrow's Solution, is a drying soak that can be used if the lesions ooze.
  • Large blisters can be drained by a health care provider.
  • Antibiotics may be needed if the skin is broken and infection is suspected.
  • High strength topical steroids are often used to control itching.
  • Severe cases may be treated with oral methotrexate.
  • Aluminum chloride 20% (Drysol) may help in cases made worse by sweating.
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