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Dyshidrotic Eczema

Dyshidrotic eczema is refers to a number of different skin conditions in which the skin is red and irritated. It can occur at any age, but it is more common in adults. Typically it appears as tiny water blisters on the hands and sometimes the feet. The hands are affected in isolation in 80% of cases, the feet solely (sic) in 10% of cases and both the hands and feet in the remaining 10% of cases. Dyshidrotic eczema can be extremely itchy. In the United States, up to 20 percent of all people with eczema affecting the hands may have dyshidrotic eczema. The condition tends to occur more frequently in areas with a warmer climate. Mostly it is found on the body of the palms of the hands, sides of the fingers, and soles of the feet.

Dyshidrotic Eczema Causes

The cause of dyshidrotic eczema is not known, but it occasionally appears to be seasonal.  The stress may also be a cause of this disease. Although it may not directly contribute in causing this disease but it creates other situations which lead to this disease. Very often it is seen in association with those that are atopic.

Dyshidrotic EczemaSymptoms

The first (acute) stage shows tiny blisters (vesicles) deep in the skin of the palms, fingers, instep or toes. The blisters are often intensely itchy or have a burning feeling. Usually the first symptom of eczema is intense itching; this itching can be very uncomfortable and individuals may tend to scratch the skin. 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.

Common symptoms of dyshidrotic eczema include:

  • The main symptom is intense itching and burning at the site of the blistering.
  • There are cracks or fissures on the finger of hands and toes etc.
  • Peak incidence occurs in patients aged 20-40 years, although the disorder also occurs in teenagers and older patients.
  • There may be pain if the blisters are of big size.
  • This disease is more common in female as compared to males. Female to male ratio is 2:1.
  • 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.

Dyshidrotic EczemaTreatment

The primary treatment of Dyshidrotic eczema is to removal of the cause. If the cause can not be identified then the treatment is taken lots of time. Potent topical steroids should be applied to the affected areas in the night. They help reduce inflammation and itching. The more potent products should not be used for more than two weeks unless your doctor advises otherwise. Steroid creams are used when the skin is blistered or weeping. Steroid ointments are used for the chronic dry stage.

The treatment program I put you on will help control or clear the eczema, but it is not a cure. Even if the disorder is totally cleared, you will still be predisposed to have repeated episodes. Repeat treatment may be needed and some patients may require continuous therapy. Corticosteroid creams and ointments play an important role in the treatment of this disorder. Application of corticosteroid under plastic occlusion may increase their effectiveness. Pustular psoriasis of the palms and soles, epidermolysis bullosa hereditaria, hand-foot-mouth-disease, acrodermatitis enteropathica and scabies in children are possible differential diagnoses for vesicles on the palms and soles. In severe cases oral prednisolone can be used in short courses. In the most severe and recalcitrant cases other immunosuppressants like Azathioprine, Methotrexate and even Cyclosporine have been used.

 
 

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