Dyshidrotic Eczema | UVTREAT

What is Dyshidrotic Eczema?

Dyshidrotic eczema is a chronic inflammatory skin condition marked by small blisters and dry, itchy skin. Also known as dyshidrosis, acute palmoplantar eczema, or pompholyx, it can cause a blistering rash, affecting palms, fingers’ sides, and feet soles. [1]

Around half of dyshidrotic eczema sufferers also have other eczema forms, like contact or atopic dermatitis. It’s not contagious and doesn’t transmit through touch. While symptoms may resolve in weeks with or without treatment, they can persist over months or years.

Dyshidrotic Eczema Causes

The exact cause of dyshidrotic eczema remains uncertain. It predominantly affects adults aged 20-40, particularly those with allergies like family history, hay feveror, or other eczema types. [2]

Factors increasing the risk include:

• Past history of dermatitis
• Allergies
• Familial predisposition, suggesting a genetic link
• Exposure to allergens or irritants
• Smoking
• Hyperactive sweat glands
• UV radiation exposure

Triggers of dyshidrotic eczema include:

• Stress
• Frequently wet or sweaty hands or feet
• Contact with metals like nickel, cobalt, or chromium salts [3]
• Warm, humid weather
• Allergies to substances like cement or certain metals
• Activation of the immune system, leading to skin inflammation
• Certain treatments for a weakened immune system

Dyshidrotic Eczema Symptoms

Some people experience frequent episodes, leading to chronic hand dermatitis with symptoms like:

• Itching on the palms of the hands, finger sides, and soles of feet [4]
• Blisters on fingers, toes, palms, and soles
• Red, tough skin
• Scaling and peeling
• Cracked skin
• Sweaty skin around blisters
• Thickened, discolored nails
• Itching or burning before blisters emerge

Who Does Dyshidrotic Eczema Affect?

Dyshidrotic eczema affects a wide range of individuals but is more prevalent among those aged 20-40, particularly females, and those with a personal or family history of eczema or contact dermatitis. [5] About half of cases occur in individuals prone to allergic reactions to foreign substances, including those receiving immunoglobulin infusions for immune deficiency.

Females may have a higher risk due to increased interaction with specific antigens like nickel and cobalt found in jewelry.

Dyshidrotic Eczema Diagnoses

Lab tests aren’t definitive in diagnosing dyshidrotic eczema, but if you observe blisters on your hands and feet, it’s crucial to consult a dermatologist, a specialist in skin disorders. Your diagnosis might also come from a general healthcare provider.

During the examination, the dermatologist will carefully inspect your hands, feet, and nails. They may recommend tests to rule out conditions like athlete’s foot that share similar symptoms. They may also inquire about your medical history and symptoms, focusing on any potential contact with irritants.

A physical examination will follow to eliminate other conditions such as allergic contact dermatitis or rare autoimmune diseases. Additional tests may include:

• Patch skin testing: These can determine if you have an allergy to metals like nickel. Small patches containing various substances are applied to your skin during this procedure to observe any adverse reactions.
• Blood tests: Screen for autoimmune factors.
• Skin scraping or biopsy: To detect infections or other causes of the rash.

Treating Dyshidrotic Eczema

Treatment options include:

• Moisturizing lotion or cream: Prescribed by your doctor, these may contain steroids or ceramides to reduce swelling and eliminate blisters. Using a wet compress after application helps skin absorb the medicine. [6]
• Calcineurin creams: These can also alleviate inflammation.
• Oral steroid medicines: Reserved for severe symptoms.
• Draining blisters: Done by a dermatologist to prevent worsening the eczema.
• Antihistamines: These may include diphenhydramine or loratadine to relieve itching. Applying cold, wet compresses multiple times a day can also help.
• Injectable biologic medicines: These may include dupilumab, which may assist with dyshidrotic eczema.

Consistent use of moisturizing lotion or cream is essential for managing dryness as blisters heal. Further tests may be needed to explore other potential causes if symptoms persist.

Alternative treatments if initial options fail include:

• Light therapy: Utilizing UV light, often preceded by sensitizing medication. [7]
• Botulinum toxin injections: To reduce sweating in hands and feet, preventing blister triggers.
• Immune system-slowing medications: Tacrolimus ointments can reduce swelling and irritation, offering steroid-free alternatives.

Managing Dyshidrotic Eczema at Home

To control blisters at home:

• Wash hands and feet daily with lukewarm water and mild, fragrance-free soap. Pat skin dry gently afterward.
• Use a humidifier in dry weather to prevent skin cracking.
• Apply a thick moisturizer to hands and feet after showering to lock in moisture. [8]
• Remove rings before washing hands to prevent moisture trapping.
• Wear gloves with cotton liners when handling water, like while washing dishes.
• Avoid allergens that trigger eczema if allergies are a factor.
• Resist scratching blisters to prevent worsening.

Complications of Dyshidrotic Eczema

Dyshidrotic eczema can lead to skin infections caused by bacteria like Staphylococcus. Your healthcare provider may test skin swabs for infection and treat any detected infections with antibiotic medicine.

Living with Dyshidrotic Eczema

Living with dyshidrotic eczema can be challenging, but many people manage it. General skin care tips may include:

• Using lukewarm water and mild, fragrance-free cleansers
• Drying affected areas thoroughly
• Applying antibacterial cream or ointment
• Covering affected areas with bandages or gauze
• Changing bandages daily
• Using latex-free gloves for dishwashing
• Avoiding irritants like detergents or solvents
• Protecting skin from weather extremes
• Reducing stress may also help in symptom management.

Summary

Dyshidrotic eczema is a common skin condition causing pain, redness, itching, cracked skin, and nail changes. It can occur once or intermittently throughout life. While no cure exists, treatments like steroid ointments, antihistamines, or light therapy can help manage symptoms.

For personalized assistance, consult healthcare providers or simply fill out the form at UVTREAT for tailored solutions. Severe cases may need prescription medications or other therapies. With proper skin care, you can lessen the impact of dyshidrotic eczema.