Wyprysk dyshidrotyczny
Etiologia i przyczyny
Wyprysk dyshidrotyczny (pompholyx) to przewlekła dermatoza charakteryzująca się pęcherzykowatymi zmianami na dłoniach i stopach, o nie do końca poznanej, wieloczynnikowej etiologii. Choroba wykazuje silne powiązania genetyczne, w tym dziedziczenie autosomalne dominujące z lokusem na chromosomie 18, oraz częste współwystępowanie z atopowym zapaleniem skóry (około 50% przypadków). Czynniki wyzwalające obejmują kontakt z metalami takimi jak nikiel, kobalt (zalecana dieta niskokobaltowa z limitem spożycia około 12 μg/dzień) i chrom, alergiczne i drażniące kontaktowe zapalenie skóry (w tym alergeny kosmetyczne i detergenty), infekcje grzybicze (np. tinea pedis) oraz warunki środowiskowe, takie jak wysoka wilgotność, promieniowanie UVA i ekstremalne temperatury. Nadmierna potliwość i częsty kontakt z wodą również zaostrzają objawy, podobnie jak stres psychologiczny, który moduluje odpowiedź immunologiczną.
- Etiologia wyprysku dyshidrotycznego (Pompholyx)
- Czynniki wyzwalające i zaostrzające
- Metale jako czynnik wyzwalający
- Kontaktowe zapalenie skóry
- Infekcje skórne
- Czynniki środowiskowe
- Nadmierna potliwość i ekspozycja na wodę
- Stres i czynniki psychologiczne
- Inne czynniki wyzwalające
- Rola układu immunologicznego
- Defekty bariery skórnej
- Czynniki demograficzne i epidemiologiczne
- Podsumowanie etiologii
Etiologia wyprysku dyshidrotycznego (Pompholyx)
Wyprysk dyshidrotyczny (łac. pompholyx, dyshidrotic eczema) to przewlekła dermatoza charakteryzująca się występowaniem intensywnie swędzących, wypełnionych płynem pęcherzyków na dłoniach, stopach, a szczególnie na bocznych powierzchniach palców, podeszwach stóp i wewnętrznej stronie dłoni.12 Nazwa „dyshidrotic” pochodzi od pierwotnego, obecnie już nieaktualnego, przekonania z 1873 roku, że choroba ma związek z dysfunkcją gruczołów potowych, co zostało później obalone.34 Termin „pompholyx” wywodzi się natomiast z greckiego słowa oznaczającego „bąbel”, co trafnie opisuje charakterystyczne zmiany skórne.5
Nieznana przyczyna podstawowa
Dokładna etiologia wyprysku dyshidrotycznego pozostaje nieznana.67 Pomimo wielu badań nie udało się określić jednego konkretnego czynnika sprawczego. Uważa się, że choroba ma charakter wieloczynnikowy, będąc wynikiem złożonych interakcji między predyspozycjami genetycznymi, czynnikami środowiskowymi i odpowiedzią immunologiczną.89 Obecne badania wskazują, że jest to reakcja skórna wywołana przez różne czynniki endogenne i egzogenne.2
Predyspozycje genetyczne
Istnieją dowody sugerujące genetyczne podłoże wyprysku dyshidrotycznego:8
- Choroba ma tendencję do występowania rodzinnego, co wskazuje na genetyczny komponent1011
- Badanie przeprowadzone w 2005 roku przez badaczy z Anhui Medical University i Chinese National Human Genome Center w Pekinie analizowało chińską rodzinę, w której schorzenie występowało przez cztery pokolenia w mechanizmie dziedziczenia autosomalnego dominującego. Analiza haplotypów zidentyfikowała lokus dla tego schorzenia na chromosomie 1812
- Około 50% pacjentów z wypryskem dyshidrotycznym cierpi również na atopowe zapalenie skóry lub ma rodzinną historię atopii12
Związek z atopią
Atopia i schorzenia atopowe wydają się mieć silny związek z wyprykiem dyshidrotycznym, choć dane naukowe są niejednoznaczne:7
- Badania wykazują, że 50% pacjentów z wyprykiem dyshidrotycznym ma również atopowe zapalenie skóry2
- Osoby z historią innych schorzeń atopowych, takich jak alergiczny nieżyt nosa (katar sienny) czy astma, mają zwiększone ryzyko rozwoju wyprysku dyshidrotycznego1314
- Niektóre badania kwestionują jednak ten związek, co wskazuje na złożoność etiologii15
Czynniki wyzwalające i zaostrzające
Chociaż podstawowa przyczyna wyprysku dyshidrotycznego pozostaje nieznana, zidentyfikowano szereg czynników, które mogą wyzwalać lub zaostrzać objawy tej choroby.616
Metale jako czynnik wyzwalający
Kontakt z metalami jest jednym z najlepiej udokumentowanych czynników prowokujących wyprysk dyshidrotyczny:617
- Nikiel jest najczęstszym alergenem kontaktowym związanym z wyprykiem dyshidrotycznym. Badania wykazały zwiększone wydzielanie niklu w moczu podczas zaostrzeń choroby9
- Kobalt także może powodować wyprysk dyshidrotyczny. Zaproponowano dietę niskokobaltową, która ma pomóc pacjentom w ograniczeniu spożycia kobaltu i utrzymaniu poziomu w surowicy poniżej progu powodującego zaostrzenia (około 12 μg/dzień)9
- Chrom i jego związki, szczególnie dichromiany, stanowią kolejny ważny alergen wywołujący objawy18
Ekspozycja na te metale może zachodzić poprzez kontakt skórny (np. biżuteria, monety, narzędzia) lub drogą pokarmową (żywność zawierająca nikiel lub kobalt).1920
Kontaktowe zapalenie skóry
Wyprysk dyshidrotyczny może być wywoływany lub zaostrzany przez alergiczne i drażniące kontaktowe zapalenie skóry:7
- Alergiczne kontaktowe zapalenie skóry – 3-letnie prospektywne badanie (N = 120) przyczyn wyprysku dyshidrotycznego wykazało, że w 67,5% przypadków choroba była związana z ekspozycją kontaktową, w tym na kosmetyki (31,7%) i metale (16,7%). Alergia kontaktowa występowała u 74,2% pacjentów18
- Najczęstsze alergeny obejmowały: nikiel, żel pod prysznic, chrom, substancje zapachowe, szampon i balsam peruwiański; rzadziej występujące alergeny to lanolina, kobalt, tiuram, siarczan laurylu, świeży tytoń, p-fenylenodiamina (PPD), formaldehyd, parabeny i galusan oktylu21
- Kontaktowe zapalenie skóry z podrażnienia – może być wywołane przez detergenty, rozpuszczalniki, kwasy/zasady, chemikalia i glebę122
- Osoby wykonujące zawody wymagające częstego moczenia rąk (np. fryzjerzy, pracownicy służby zdrowia) lub kontaktu z cementem (pracownicy budowlani) są szczególnie narażone2324
Infekcje skórne
Infekcje skórne, szczególnie grzybicze, mogą być czynnikiem wyzwalającym wyprysk dyshidrotyczny:16
- Grzybica stóp (tinea pedis) może wywoływać wyprysk dyshidrotyczny jako reakcję typu id (reakcja odogniskowa)925
- Zespół „jedna stopa, dwie dłonie” opisuje sytuację, gdy grzybica jednej stopy powoduje wyprysk dyshidrotyczny na obu dłoniach25
- Infekcje bakteryjne również mogą zaostrzać objawy lub rozwijać się wtórnie w miejscach uszkodzenia bariery skórnej26
Czynniki środowiskowe
Warunki środowiskowe mogą odgrywać istotną rolę w wyzwalaniu lub zaostrzaniu wyprysku dyshidrotycznego:9
- Ciepła, wilgotna pogoda – zaostrzenia często występują wiosną i latem16
- Promieniowanie ultrafioletowe – ekspozycja na UVA może wyzwalać objawy7
- Ekstremalne zmiany temperatury – zarówno wysokie, jak i niskie temperatury mogą powodować zaostrzenia27
- Skrajnie suche lub wilgotne powietrze – wpływają na kondycję skóry i mogą przyczyniać się do wystąpienia objawów27
Nadmierna potliwość i ekspozycja na wodę
Wbrew pierwotnej teorii, że wyprysk dyshidrotyczny jest związany z dysfunkcją gruczołów potowych, nadmierna potliwość i częsty kontakt z wodą są czynnikami zaostrzającymi:7
- Nadpotliwość (hyperhidrosis) – nadmierne pocenie się dłoni i stóp może zaostrzać objawy1628
- Częste moczenie rąk – zawody wymagające regularnego kontaktu rąk z wodą (np. fryzjerzy, pracownicy służby zdrowia, floryści) zwiększają ryzyko wystąpienia choroby629
- Pocenie się wywołane przez stres emocjonalny lub ciepło może przyspieszać powstawanie pęcherzyków u niektórych osób25
Stres i czynniki psychologiczne
Stres psychologiczny jest powszechnie uznanym czynnikiem wyzwalającym wyprysk dyshidrotyczny:613
- Wielu pacjentów zgłasza nawroty wyprysku dyshidrotycznego w okresach zwiększonego stresu18
- Pierwszy atak choroby jest często wyzwalany przez intensywne emocje, takie jak smutek lub stres30
- Stres emocjonalny może wpływać na odpowiedź immunologiczną, przyczyniając się do zaostrzenia objawów skórnych31
Inne czynniki wyzwalające
Badania zidentyfikowały również inne potencjalne czynniki wyzwalające wyprysk dyshidrotyczny:32
- Palenie tytoniu – wykazano związek między paleniem a występowaniem wyprysku dyshidrotycznego7
- Doustne środki antykoncepcyjne i aspiryna – mogą przyczyniać się do wystąpienia objawów u niektórych osób733
- Leczenie dożylnymi immunoglobulinami – raportowano występowanie wyprysku dyshidrotycznego jako działania niepożądanego1034
- Zakażenie HIV – opisano przypadki wyprysku dyshidrotycznego jako objawu zakażenia HIV, a także jako syndromu rekonstytucji immunologicznej po wprowadzeniu wysoce aktywnej terapii antyretrowirusowej3536
- Inhibitory punktów kontrolnych – odnotowano przypadki wyprysku dyshidrotycznego wywołanego przez tremelimumab35
Rola układu immunologicznego
Coraz więcej dowodów wskazuje na istotną rolę układu immunologicznego w patogenezie wyprysku dyshidrotycznego:34
- Badania sugerują, że wyprysk dyshidrotyczny jest zwykle zaburzeniem reaktywnym, w którym liczne białe krwinki (leukocyty) migrują z krwi do skóry, tworząc charakterystyczne pęcherzyki37
- Jedno z badań zaproponowało, że etiologia obejmuje złożony proces immunologiczny z udziałem dopełniacza, mieloperoksydazy (białka lizosomalnego przechowywanego w ziarnistościach azurofilnych neutrofili) i limfocytów T34
- Wykazano, że spożycie jonów metali, takich jak kobalt, może wywoływać reakcje nadwrażliwości typu I i IV2
- U pacjentów z osłabionym układem immunologicznym zaobserwowano zwiększoną podatność na wyprysk dyshidrotyczny38
Defekty bariery skórnej
Nieprawidłowości w funkcjonowaniu bariery skórnej mogą przyczyniać się do rozwoju wyprysku dyshidrotycznego:9
- Przewlekłe zapalenie skóry rąk, w tym wyprysk dyshidrotyczny, powiązano z defektami bariery skórnej9
- W niektórych przypadkach stwierdzono związek z mutacjami w genie filagryny, kluczowego białka dla prawidłowej funkcji bariery skórnej, jednak wyniki te nie osiągnęły istotności statystycznej9
- Osłabiona bariera skórna zwiększa podatność na alergeny i czynniki drażniące, co może przyczyniać się do wystąpienia objawów39
Czynniki demograficzne i epidemiologiczne
Wystąpienie wyprysku dyshidrotycznego może być związane z określonymi czynnikami demograficznymi:10
- Choroba najczęściej dotyka osoby dorosłe w wieku 20-40 lat1040
- Kobiety wydają się być bardziej podatne na rozwój choroby niż mężczyźni4142
- Badacze sugerują, że większa częstość występowania u kobiet może wynikać z częstszego kontaktu z określonymi alergenami, takimi jak nikiel i kobalt w biżuterii43
- Wyprysk dyshidrotyczny stanowi 5-20% wszystkich przypadków wyprysku rąk44
Podsumowanie etiologii
Wyprysk dyshidrotyczny to złożona dermatoza o wieloczynnikowej etiologii, która wciąż nie jest w pełni wyjaśniona.87 Choroba najprawdopodobniej rozwija się w wyniku interakcji między predyspozycjami genetycznymi, czynnikami środowiskowymi, funkcją bariery skórnej i odpowiedzią immunologiczną.4045
Zidentyfikowano liczne czynniki wyzwalające, takie jak kontakt z metalami (nikiel, kobalt, chrom), alergeny kontaktowe, detergenty, infekcje grzybicze, stres, nadmierna potliwość i warunki środowiskowe.616 Unikanie znanych czynników wyzwalających może pomóc w kontrolowaniu objawów, jednak ze względu na złożoność choroby, pełne uniknięcie zaostrzeń może być trudne.46
Dalsze badania są potrzebne, aby lepiej zrozumieć mechanizmy patogenetyczne leżące u podstaw wyprysku dyshidrotycznego i opracować skuteczniejsze strategie leczenia dla pacjentów cierpiących na tę uciążliwą chorobę.4748
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Materiały źródłowe
- #1 Pompholyx (dyshidrotic) eczema – National Eczema Societyhttps://eczema.org/information-and-advice/types-of-eczema/pompholyx-eczema-2/
Pompholyx eczema (also known as dyshidrotic eczema) is a type of eczema that affects the hands and feet. It involves the development of intensely itchy, watery blisters, affecting the sides of the fingers, the palms of the hands and soles of the feet. […] The exact causes of pompholyx eczema are not known. It is thought that stress, sensitivity to metal compounds (such as nickel, cobalt or chromate), heat and sweating can aggravate this condition. […] Fifty percent (50%) of people with pompholyx have atopic eczema as well, or a family history of atopic eczema. Pompholyx eczema can coexist with fungal infections, so assessment should include checking for the presence of any fungal infection on the hands and/or feet. […] Pompholyx eczema occurs on the palms of the hands, fingers and feet. The skin in these areas is particularly prone to exposure to potential sources of irritation and aggravation.
- #2 Dyshidrotic Eczema (Pompholyx): Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/1122527-overview
Dyshidrotic eczema is a type of eczema (dermatitis) that is characterized by a pruritic vesicular eruption (bullae, or blisters) on the fingers, palms, and soles; typically these intensely itchy blisters develop on the edges of the fingers, toes, palms, and soles of the feet. […] The etiology of dyshidrotic eczema is unresolved and is believed to be multifactorial. Dyshidrotic eczema is considered to be a reaction pattern caused by various endogenous conditions and exogenous factors. […] Dyshidrotic eczema may be associated with atopy and familial atopy. Of patients with dyshidrosis, 50% have atopic dermatitis. […] Exogenous factors (eg, contact dermatitis to nickel, balsam, cobalt; sensitivity to ingested metals; dermatophyte infection; bacterial infection) may trigger episodes. […] Evidence shows that the ingestion of metal ions such as cobalt can induce type I and type IV hypersensitivity reactions.
- #3 Dyshidrotic Eczema: A Common Cause of Palmar Dermatitishttps://pmc.ncbi.nlm.nih.gov/articles/PMC7647841/
Dyshidrotic eczema (DE) or acute palmoplantar eczema is a common cause of hand and foot dermatitis in adults. […] The exact cause of DE has not been established, but there are several risk factors for its occurrence, including atopic dermatitis, exposure to contact allergens and/or irritants, hyperhidrosis, smoking, exposure to ultraviolet light, and intravenous immunoglobulin use. […] The term dyshidrosis was first used in 1873 to describe the blistering of the palms and soles, which was believed to be related to the sweat glands. […] However, DE is not related to any abnormality of the sweat glands. […] The clinical presentation of DE is a sudden eruption of intensely pruritic vesicles in the hands and feet, particularly in the lateral and dorsal aspects of the fingers. […] The vesicles are deep-seated and can be multilocular with a characteristic tapioca pudding appearance and can coalesce into bullae. […] The management of DE focuses on the treatment of acute eruptions and long-term skincare. […] The treatment of acute DE is based on the severity of the presentation. […] DE treatment is considered refractory when there is a lack of improvement after two to four weeks of adequate therapy.
- #4 Dyshidrotic Eczema: Difficulty of Etiological Diagnosis and Therapeutic Managementhttps://clinmedjournals.org/articles/cmil/cmil-7-176.php?jid=cmil
Dyshidrotic eczema (DE) or acute palmoplantar eczema is a common cause of hand dermatitis in adults. […] The exact cause of DE has not been established, but there are several risk factors for its occurrence, including atopic dermatitis, exposure to contact allergens and/or irritants, hyperhidrosis, smoking, exposure to ultraviolet light, and intravenous immunoglobulin use. […] The diagnosis is mostly clinical and suggested by a recurrent rash of acute onset with vesicles and bullae located in the fingers extending to the palmar surfaces of the hands. […] DE is also known as acute palmoplantar eczema and is an intensely pruritic, vesicular eruption that presents in the hands, feet, or both. […] The term „dyshidrosis” was first used in 1873 to describe the blistering of the palms and soles, which was believed to be related to the sweat glands.
- #5 Dyshidrotic Dermatitis Symptoms, Causes, and Treatmenthttps://www.verywellhealth.com/dyshidrotic-dermatitis-pompholyx-1069255
Dyshidrotic dermatitis is a skin condition characterized by small, itchy blisters over the palms, fingers, or the soles of the feet. […] Also known as dyshidrotic eczema, foot-and-hand eczema, and pompholyx, it can be associated with atopic dermatitis and seasonal allergies. […] The cause of dyshidrotic dermatitis isn’t known. […] There is a strong link between this condition and atopic dermatitis. […] Dyshidrotic dermatitis is also more common if you have seasonal allergies or a history of contact dermatitis. […] The word „dyshidrotic” stems from a now outdated belief that this condition is caused by sweat gland malfunction. „Pompholyx” comes from the Greek word for „bubble,” which describes the blisters. […] Many factors can contribute to a flareup of dyshidrotic dermatitis or make an existing rash worse: Contact with metal, especially nickel: Common exposures include zippers, jewelry, coins, and belt buckles.
- #6 Pompholyx (dyshidrotic eczema)https://www.nhs.uk/conditions/pompholyx/
Pompholyx (dyshidrotic eczema) is a type of eczema that affects the hands or feet. […] It’s not clear exactly what causes pompholyx. […] Certain things are thought to cause symptoms in some people, including: contact with strong chemicals like soaps, cleansers and detergents, an allergy or sensitivity to certain metals, such as nickel or cobalt, getting your hands wet regularly for example, if you’re a hairdresser, stress, heat and sweat.
- #7 Dyshidrotic eczema (Pompholyx, Vesicular Hand Eczema) â DermNethttps://dermnetnz.org/topics/dyshidrotic-eczema
The cause of dyshidrotic eczema (pompholyx) is not known. […] It is not related to occlusion of sweat glands as was first thought when the disease was recognised over 100 years ago, but there are some factors associated with the disorder, including: Atopy the evidence is mixed with some reporting it as a risk and others not […] Contact dermatitis: Allergic contact dermatitis to a variety of antigens including nickel, chromium, and cobalt […] Irritant contact dermatitis may exacerbate the condition. […] Fungal infection Tinea pedis can be associated with a dyshidrotic-like eruption […] Photoinduction associated with ultraviolet A exposure […] Immunoglobulin therapy […] Hyperhidrosis excessive sweating is an aggravating factor […] Other factors: Seasonal variation can also aggravate a recurrence […] Smoking […] Oral contraceptive pill […] Aspirin.
- #8 Dyshidrotic Eczema: Symptoms, Causes, Treatment | National Eczema Associationhttps://nationaleczema.org/eczema/types-of-eczema/dyshidrotic-eczema/
Dyshidrotic eczema is a chronic skin condition that causes small, itchy blisters on the fingers, hands and feet. […] The actual cause of dyshidrotic eczema is not known. It is often more common in people who have another form of eczema, such as atopic dermatitis. […] It also tends to run in families, suggesting a genetic component. […] Some common dyshidrotic eczema triggers include contact allergens, lifestyle factors, environmental factors, some medications, and skin infections.
- #9 Dyshidrotic Eczema (Pompholyx): Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/1122527-overview
Emotional stress and environmental factors (eg, seasonal changes, hot or cold temperatures, and humidity) have been reported to exacerbate dyshidrosis. […] In some patients, a distant fungal infection can cause palmar pompholyx as an id reaction. […] Chronic hand dermatitis, including dyshidrotic eczema, has also been associated with defects in the skin barrier, and in a few cases, it has also been associated with mutations in the filaggrin gene; however, these have not reached statistical significance. […] Nickel sensitivity may be a significant factor in dyshidrotic eczema. […] Increased nickel excretion in the urine has been reported during exacerbations of pompholyx. […] A point-based low-cobalt diet has been proposed to help patients limit cobalt ingestion and to keep the serum level below the threshold for developing flares (approximately 12 g/day).
- #10 Dyshidrotic Eczema: Pictures, Symptoms, Causes & Treatmenthttps://www.webmd.com/skin-problems-and-treatments/eczema/dyshidrotic-eczema
Dyshidrotic eczema causes blisters on your hands and feet as well as other symptoms. […] Doctors aren’t sure what causes dyshidrotic eczema. It mostly affects adults aged 20-40, and you’re more likely to get it if you have allergies such as hay fever, a family history of dyshidrotic eczema, or other forms of eczema. […] While doctors don’t know precisely what causes dyshidrotic eczema, it often runs in families, which suggests it might be genetic. […] Several things can set off dyshidrotic eczema, including: Stress, Contact with metals such as nickel, cobalt, or chromium salts on your job or from things such as costume jewelry, Sweaty or wet hands and feet, Warm, humid weather, HIV infection, Certain treatments for a weak immune system (immunoglobulin), Seasonal allergies.
- #11 3 Reasons Not To Pop Dyshidrotic Eczema Blisters | MyEczemaTeamhttps://www.myeczemateam.com/resources/reasons-not-to-pop-dyshidrotic-eczema-blisters
Do you have itchy hands and feet with tiny fluid-filled blisters? This may be a sign of a type of eczema called dyshidrotic eczema also called pompholyx or dyshidrosis. […] No one knows what causes this skin condition, though scientists believe it’s tied to factors including: Genetics The condition tends to run in families. […] Allergy or contact dermatitis reaction Touching certain substances including nickel, cobalt, and ingredients in shampoos, detergents, or soaps can trigger dyshidrotic eczema in some people. […] Submersion or dampness If you work at a job where your hands are often in water or you sweat a lot, you may be more likely to get dyshidrotic eczema. […] However, anyone can get dyshidrotic eczema at any time.
- #12 Dyshidrosis – Wikipediahttps://en.wikipedia.org/wiki/Dyshidrosis
Causes Unknown. […] Whilst the exact causes of the condition are currently unknown, its triggers may include food allergens from a wide range of foods, including tuna, tomato, pineapple, chocolate, coffee, and spices among others, physical or mental stress, frequent hand washing, or metals. […] A number of studies have implicated balsam of Peru. […] A 2013 study found that dyshidrosis on the hands increased among those allergic to house dust mites, following inhalation of house dust mite allergen. […] Id reaction and irritant contact dermatitis are also possible causes. […] In 2005, researchers from Anhui Medical University and the Chinese National Human Genome Center, Beijing, theorizing that mutations in single genes could predispose the condition, ran a study of a Chinese family with the condition present across four generations via autosomal dominant inheritance. Their analysis of haplotypes within the family identified a locus for the condition on chromosome 18.
- #13 Eczema types: Dyshidrotic eczema causeshttps://www.aad.org/public/diseases/eczema/types/dyshidrotic-eczema/causes
Your risk of developing dyshidrotic eczema increases if you have one or more of the following: […] An allergy, especially to nickel or cobalt […] Dyshidrotic eczema can also begin earlier or later in life. While rare, children sometimes develop this disease. […] This is still a bit of a mystery. In studying this disease, researchers have learned that it is NOT caused by a problem with a persons sweat ducts, as previously thought. […] It appears that people who get dyshidrotic eczema have a hypersensitivity to something. The list of things that can cause this hypersensitivity include: […] When you come into contact with something that causes a hypersensitivity, its thought that this triggers the dyshidrotic eczema. […] Some people find that when they avoid what causes this hypersensitivity, they avoid flare-ups. […] If you have dyshidrotic eczema, however, stress may trigger a flare-up. […] A change in weather can also trigger a flare-up.
- #14 What Is Dyshidrotic Eczema? Symptoms, Causes, Diagnosis, Treatment, and Preventionhttps://www.everydayhealth.com/dyshidrotic-eczema/
Dyshidrotic eczema is a type of dermatitis that affects the hands and feet. It is also known as dyshidrosis, dyshidrotic dermatitis, foot-and-hand eczema, pompholyx, and vesicular eczema, according to the American Academy of Dermatology Association (AAD). […] Certain triggers can also make it flare, such as contact with irritating chemicals like soaps or detergents or hand sanitizers, sweating, seasonal changes, and sometimes even just stress. […] Other causes and triggers include allergic skin reactions, atopic dermatitis, fungal and bacterial infections, exposure to nickel or cobalt, and excessive exposure to water, according to Chesahna Kindred, MD, a dermatologist in Columbia, Maryland. […] Dyshidrotic eczema is also a side effect of intravenous immunoglobulin infusions (IVIG), which are typically used to treat certain immune system diseases. Exposure to cement is another risk factor.
- #15 Pompholyx: Causes, Symptoms, and Treatmenthttps://patient.info/skin-conditions/atopic-eczema/pompholyx
Pompholyx is also known as dyshidrotic eczema, dyshidrotic dermatitis or vesicular eczema of the hands and feet. […] The exact cause is not known. However, there are some factors that might be involved in causing or triggering the outbreaks (vesicular eruption) in some people. These are: Metals such as nickel or cobalt either on the skin or in food. […] Some research suggests that people prone to allergies (atopy) are more likely to get pompholyx, but other studies do not find this connection.
- #16 Pompholyx (dyshidrotic eczema) | nidirecthttps://www.nidirect.gov.uk/conditions/pompholyx-dyshidrotic-eczema
Pompholyx (dyshidrotic eczema) is a type of eczema. […] It’s not clear exactly what causes pompholyx, but it may be triggered or made worse by: a fungal skin infection this may be on the hands or at a distant site from the blisters (such as in between the toes) and will need treating, a reaction to something that has touched your skin such as certain metals (particularly nickel), detergents, household chemicals, soap, shampoo, cosmetic products or perfume, stress, sweating pompholyx is more common in spring and summer, in warmer climates, and in people with Excessive sweating (hyperhidrosis).
- #17 Dyshidrosis – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/dyshidrosis/symptoms-causes/syc-20352342
Dyshidrosis is also called dyshidrotic eczema and pompholyx. […] The cause of dyshidrosis isn’t known. It tends to happen in people who have a skin condition called atopic dermatitis (eczema) and allergic conditions, such as hay fever or glove allergy. Dyshidrosis isn’t contagious. […] Risk factors for dyshidrosis include: Stress. Dyshidrosis appears to be more common during times of emotional or physical stress. Exposure to certain metals. These include cobalt and nickel often in an industrial setting. Sensitive skin. People who develop a rash after contact with certain irritants are more likely to form the blisters of dyshidrosis. Atopic dermatitis. Some people with atopic dermatitis may have dyshidrosis.
- #18 Dyshidrotic Eczema (Pompholyx): Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/1122527-overview
Dyshidrotic eczema outbreaks are sometimes associated with exposure to other sensitizing chemicals or metals (eg, chromium, carba mix, fragrance mix, diaminodiphenylmethane, dichromates, benzoisothiazolones, paraphenylenediamine, perfumes, fragrances, balsam of Peru, or Primula plant). […] This is a possible factor in dyshidrotic eczema. Many patients report recurrences of pompholyx during stressful periods. […] A 3-year prospective study (N = 120) of the causes of dyshidrotic eczema found causes of pompholyx related to contact exposure (67.5%), including to cosmetic products (31.7%) and metals (16.7%); interdigital-plantar intertrigo (10%); and internal factors (6.7%); an additional 15% of patients had undiagnosed (idiopathic) causes probably related to atopic factors. […] Contact allergy was found in 89 (74.2%) of the 120 patients.
- #19 Dyshidrotic Eczema (Dyshidrosis): Causes, Pictures, and Morehttps://www.healthline.com/health/dyshidrotic-eczema
Dyshidrotic eczema, also known as pompholyx, dyshidrosis, or palmoplantar eczema, is a skin condition in which blisters develop on your soles, palms, or fingers. […] The exact cause of dyshidrotic eczema is unknown. Sweat commonly triggers the condition, although experts do not know precisely why. […] People with dyshidrotic eczema may have a hypersensitivity to: metal, particularly cobalt or nickel; a specific ingredient in a soap, moisturizer, or other personal care product; certain medications, such as birth control or aspirin; smoking tobacco; an intravenous immunoglobulin (IVIG) infusion. […] Other common triggers include stress and weather changes. […] The exact cause is unknown, but it may stem from hypersensitivity to certain metals, medical treatments, tobacco smoke, and other substances. Stress and weather changes may also trigger it. […] Dyshidrotic eczema can affect people who work with products containing various metals and those with asthma, eczema, or other allergies and sensitivities.
- #20 Hand Eczema and Food Allergies – Dr Ben Medical – Men’s Health Clinic | Women’s Health Singaporehttps://dbclinic.com.sg/hand-eczema-and-food-allergies/
Although the clinical evidence between eczema and food allergies remains much to be elucidated, it is worth exploring the relationship between dietary intake of nickel and dyshidrotic eczema. […] Nickel is one of the common elementary microminerals found in most of our staple diets. It is clinically observed that nickel in diet can predispose an atopic person to dermatitis (skin inflammation), with the hands being one of the common sites associated with nickel dermatitis. A diet low in nickel has shown improvement in eczema conditions. […] Exposure to nickel may lead to sensitisation of the body against nickel. Over time, with repeated exposure to nickel from the diet, the body develops an allergic reaction that manifests as skin inflammation.
- #21 Dyshidrotic Eczema (Pompholyx): Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/1122527-overview
The most frequent allergens were nickel, shower gel, chromium, fragrance, shampoo, and balsam of Peru; less frequent allergens were lanolin, cobalt, thiuram, lauryl sulfate, fresh tobacco, p-phenylenediamine (PPD), formaldehyde, parabens, and octyl gallate. […] In summary, the most frequent causes of pompholyx related to contact with substances were hygiene product intolerance (46.7%), metal allergy (25%), and others (28.3%).
- #22 Pompholyx (dyshidrotic) eczema – National Eczema Societyhttps://eczema.org/information-and-advice/types-of-eczema/pompholyx-eczema-2/
An irritant reaction could be the result of contact with potential irritants such as soap, detergents, solvents, acids/alkalis, chemicals and soil. […] Or there could be an allergic reaction to a substance that is not commonly regarded as an irritant, such as rubber, nickel, or dyes in leather shoes. […] Pompholyx can occur as a single episode, but for most people, it is a chronic type of eczema that will come and go with a flare lasting 2-3 weeks.
- #23 Dyshidrotic Dermatitis Symptoms, Causes, and Treatmenthttps://www.verywellhealth.com/dyshidrotic-dermatitis-pompholyx-1069255
Prolonged damp hands or feet: People who work in professions that require their hands to be in contact with water many times per day (for example, hair stylists and medical professionals) may develop dyshidrotic eczema on their hands. […] Hyperhidrosis (excessive sweating): In addition to being wet, sweat may irritate the skin. […] Weather: Temperature extremes or changes in humidity may trigger a flare. […] Emotional stress: Emotional stress can trigger a flare.
- #24 Dyshidrotic Eczema : Page 3 of 5 : Dermatology and Skin Surgery Center – North Carolinahttps://carolinahealthyskin.com/2019/10/dyshidrotic-eczema/3/
Working with cement: People who frequently work with cement have a higher risk of developing dyshidrotic eczema. […] What causes dyshidrotic eczema? While researchers have discovered that some people are more likely to get DE, the cause is still unknown. […] The cause may be a complex reaction that happens in the immune system.
- #25 Dermatitis. Hand dermatitishttps://dermnetnz.org/cme/dermatitis/hand-dermatitis
Pompholyx, also known as dyshidrotic or vesicular palmar eczema, refers to acute, chronic or relapsing blistering of the fingers, palms and/or soles. […] Sweating in response to emotional stress or heat may precipitate vesicles in some individuals. […] Pompholyx sometimes presents as an id reaction to tinea pedis (one foot, two hands syndrome) or as an expression of contact dermatitis to nickel.
- #26https://balmonds.com/blogs/blog/what-triggers-pompholyx
Pompholyx – or dyshidrotic eczema – is a common but little-understood condition, but what causes it? […] The truth is that it can be very hard to pinpoint exactly what initially sets off pompholyx, but there are some culprits worth checking out, which either be responsible or be making it worse. […] Pompholyx can be the result of reaction to something you’ve come into contact with; nickel is a common trigger, but other metals such as cobalt and chromate are also responsible. […] Substances that might have touched your skin and caused pompholyx to develop include detergents like washing-up liquid or soap; toiletries such as scented shower gel, shampoo or conditioner, and perfumes. […] Microbes can aggravate pompholyx-prone skin: this usually means a fungal infection, like thrush or athlete’s foot, but be aware that bacterial infections can develop (and will need to be treated) if your pompholyx gets very bad, cracks or is raw to the air. […] If you or get overheated and sweaty, either from the weather or exercise, you can develop pompholyx. […] As with other forms of eczema, your mental state can make you vulnerable to developing pompholyx, and anxiety and stress could well be the triggers responsible for a flare-up.
- #27 CoxHealth | Dyshidrotic Eczemahttps://www.coxhealth.com/condition/dyshidrotic-eczema/
Dyshidrotic eczema is an ongoing (chronic) skin condition. It’s also called pompholyx. […] The actual cause is unknown. It tends to be more common in people with other forms of eczema. It also tends to run in families. Other things may increase your risk of having it. […] Certain things can trigger episodes, such as: Stress, Very warm or cold weather, Very dry or humid air.
- #28 Pompholyx eczema â what is pompholyx eczema and how can it be treated?https://www.avogel.co.uk/health/skin/eczema/pompholyx-eczema/
Irritants: Pompholyx eczema has been known to appear alongside other eczema variants such as atopic eczema and contact eczema. […] Fungal skin infections: Candida albicans is a strain of fungi that inhabits your gut and grows on your skin in small, harmless amounts. […] Hyperhidrosis: Hyperhidrosis is a health condition that is associated with excessive sweating, usually in the hands, feet and armpits.
- #29 Dyshidrotic eczema: Foothill Dermatology Medical Center: Dermatologyhttps://www.foothillderm.com/blog/dyshidrotic-eczema
Dyshidrotic eczema (DE) is a common group of skin conditions in which the skin cannot protect itself as well as it should, so the person often gets itchy, dry skin. […] DE causes itchy, dry skin. People also develop small, deep-seated blisters, usually on their hands. […] DE is more common in people who immerse their hands in water frequently during the day, such as healthcare workers, hair stylists, and florists. […] While researchers have discovered that some people are more likely to get DE, the cause is still unknown. […] The cause may be a complex reaction that happens in the immune system.
- #30 Pompholyx eczema | Nursing Timeshttps://www.nursingtimes.net/dermatology/pompholyx-eczema-14-10-2003/
– The first attack is often triggered by hot weather in late spring or summer, or by intense emotions such as grief or stress. […] – It is aggravated by irritants such as detergents and solvents and some patients with pompholyx eczema are allergic to nickel. […] – Sometimes excessive washing or the use of detergents or chemicals without proper protection can irritate the hands and trigger an attack.
- #31 Dyshidrotic Eczema: Symptoms, Causes, and Treatments | MyEczemaTeamhttps://www.myeczemateam.com/resources/dyshidrotic-eczema-symptoms-causes-and-treatments
Dyshidrotic eczema, also called pompholyx or dyshidrosis, is a type of eczema that affects the hands and feet. […] Several factors can contribute to the development of atopic dermatitis and dyshidrotic eczema. […] Although doctors do not know exactly what causes the various types of eczema, the skin condition has been found to be related to inflammation. […] In some cases, dyshidrotic eczema seems to be caused by exposure to certain metals especially nickel and cobalt. […] Stress and emotion have been found to significantly affect inflammatory skin conditions. […] Extreme changes in temperature from very hot to very cold, and extremes in outdoor moisture levels, such as very humid or very dry weather, can trigger eczema symptoms. […] Some cases of dyshidrotic eczema are triggered by having consistently wet hands or feet.
- #32 What Triggers Dyshidrotic Eczema?https://www.emedicinehealth.com/what_triggers_dyshidrotic_eczema/article_em.htm
Dyshidrotic eczema (also called pompholyx or acute and recurrent vesicular hand dermatitis) is a skin condition characterized by small, intensely itchy blisters on the edges of the fingers, toes, palms of the hands, and soles of the feet. […] The cause of dyshidrotic eczema (pompholyx) is unknown, but it is most likely due to several factors. A history of atopic dermatitis is a risk factor for developing dyshidrotic eczema. […] Common triggers for dyshidrotic eczema include the following: Exposure to contact allergens or irritants, particularly metals such as nickel or cobalt, Exposure to contact irritants, such as chromium salts used in manufacturing, Fungal infection, Recent treatment with intravenous immune globulin, Smoking, Exposure to ultraviolet (UV) radiation, Stress, Pollen, Excessive sweating or prolonged contact with water, Human immunodeficiency virus (HIV) infection.
- #33 Is dyshidrotic eczema contagious? Causes and durationhttps://www.medicalnewstoday.com/articles/is-dyshidrotic-eczema-contagious
Factors that may contribute to flare-ups of symptoms include: stress, metals such as nickel, hot, humid environments, frequently having sweaty or wet hands, skin irritants, such as harsh chemicals or laundry detergent. […] A flare-up of other conditions that affect the immune system, such as allergies, could also lead to a flare-up of eczema. […] Other factors that may have an association with dyshidrotic eczema include smoking, aspirin use, and the oral contraceptive pill. […] Dyshidrotic eczema is not contagious and cannot pass between people. While the exact cause is unknown, there appears to be a link to genetics and allergies. Factors such as stress, dry skin, harsh chemicals, or sweating may make it worse.
- #34 Pompholyx: Causes, Symptoms, and Treatment | Doctorhttps://patient.info/doctor/pompholyx-pro
Pompholyx comes from the Greek word for bubble. It is a dermatitis or eczema of unknown aetiology, characterised by an itchy vesicular eruption of the hands, fingers and soles of the feet. […] One study proposed that the aetiology involved a complex immunological process which involved complement, myeloperoxidase (a lysosomal protein stored in azurophilic granules of the neutrophil) and T cells. […] There are a number of commonly identified aggravating factors such as emotional stress, allergic contact dermatitis and allergens such as chromate, neomycin or nickel. […] There is an association with atopy and tinea pedis but both pompholyx and tinea pedis are likely to occur with sweaty feet and causation is not proved. […] A genetic form has been identified. […] HIV infection and treatment of HIV-infected individuals with antiretroviral therapy (ART) have both been associated, as has intravenous immunoglobulin therapy.
- #35 Dyshidrotic Eczema (Pompholyx) Clinical Presentation: History, Physical Examination, Complicationshttps://emedicine.medscape.com/article/1122527-clinical
Patients may report a variety of factors that possibly are related to eruptions, as follows: […] Certain work exposures (eg, cobalt) or recreational exposures […] Recent exposure to contact allergens (eg, nickel, balsams, paraphenylenediamine, chromate, or sesquiterpene lactones) before condition flares […] Exposure to contact irritants before condition flares […] Recent exposure to costume jewelry (patients with palmar pompholyx and allergy to nickel) […] HIV infection […] Colebunders et al reported two cases of HIV-positive patients who developed dyshidrotic eczema as an immune reconstitution inflammatory syndrome shortly after highly active antiretroviral therapy. […] Pompholyx has also been described as a manifestation of symptomatic HIV infection, including in individuals who do not respond to topical and systemic therapies and whose condition resolves only after the initiation of combination antiretroviral therapy. […] Immune checkpoint inhibitor-induced dyshidrotic eczema has been described with tremelimumab.
- #36 Pompholyx Eczema as a Manifestation of HIV Infection, Response to Antiretroviral Therapy | HTML | Acta Dermato-Venereologicahttps://www.medicaljournals.se/acta/content/html/10.2340/00015555-0210
Pompholyx or dyshidrotic eczema is a pruritic chronic dermatitis chiefly affecting the palms of the hands and soles of the feet. The aetiology is unknown, although there is thought to be a link with nickel exposure. […] This is the first report of pompholyx as a manifestation of symptomatic HIV infection. This patients eczema failed to respond to numerous topical and systemic treatments and only improved when his immune system was reconstituted with combination ART. […] It is therefore interesting that in the case described here, of a man already immunocompromised, resolution occurred only after immune reconstitution. This presumably reflects the complex nature of the underlying pathogenesis of pompholyx and the influence of a compromised immune system in HIV infection or a direct effect of HIV infection.
- #37 Dyshidrotic eczema on the feet – MOST Skincarehttps://www.mostskincare.com/en/foot-skin-problems/dyshidrotic-eczema-on-the-feet/?srsltid=AfmBOorapFViIn7Xs3Z3raq0W92XPuXMDr-D6ILHAv19ziSydFprUPUF
Dyshidrotic eczema (also known as pompholyx or dyshidrosis) causes itchy skin and small, fluid-filled blisters. […] Dyshidrotic eczema is usually a reactive disorder whereby many white blood cells (leukocytes) migrate from the blood into the skin. Once present in the skin, these cells form the blisters or pustules that characterize dyshidrotic eczema. […] As with psoriasis or atopic dermatitis, there is no one definite cause of dyshidrotic eczema. Some common triggers include: stress, seasonal changes, contact with irritants, secondary infections from the streptococcal bacterial family, secondary infections from the dermatophyte bacterial family.
- #38 Pompholyx eczema â what is pompholyx eczema and how can it be treated?https://www.avogel.co.uk/health/skin/eczema/pompholyx-eczema/
Pompholyx eczema, otherwise known as dyshidrotic eczema, is a form of eczema that normally manifests in the hands and feet, making it extremely debilitating. […] Its estimated that 50% of pompholyx eczema cases take place in those with a familial or personal history of atopic eczema although the condition has been known to arise in other skin infections such as ringworm or athletes foot. […] There is no obvious cause of pompholyx eczema but a number of possible triggers have been identified over the years. […] Weak immune system: Your immune system is your bodys first line of defence against invading pathogens, allergens or infections. […] Poor nutrition: What affects your body internally will often dictate any external reactions, such as an outburst of eczema. […] Stress: While the exact cause of pompholyx eczema is uncertain, it is believed that stress could play a vital role in exacerbating symptoms.
- #39 Dyshidrotic Eczema: Causes, Symptoms, Diagnosis, and Treatment – DoveMedhttps://prod.cluster.dovemed.com/health-topics/focused-health-topics/dyshidrotic-eczema-causes-symptoms-diagnosis-and-treatment
Dyshidrotic eczema, also known as pompholyx eczema, is a specific type of eczema that primarily affects the hands and feet. The exact cause of dyshidrotic eczema is not fully understood, but it is believed to involve a combination of factors, including: […] Genetics: A family history of eczema or allergies may increase the risk of developing dyshidrotic eczema. […] Skin barrier dysfunction: Abnormalities in the skin’s protective barrier can make it more susceptible to irritation and inflammation. […] Allergens: Exposure to allergens like metals (e.g., nickel), certain foods, or substances in personal care products can trigger or worsen dyshidrotic eczema. […] Stress: Emotional stress and anxiety can exacerbate symptoms in some individuals.
- #40 What Causes My Dyshidrotic Eczema?https://www.healthline.com/health/eczema/dyshidrotic-eczema-causes
Dyshidrotic eczema may be caused by genetic and environmental factors. Stress and allergens can also cause flare-ups. […] While the exact cause of dyshidrotic eczema is unknown, its likely due to a combination of factors and is most common in individuals between 20 and 40 years old. Flares may result from genes, environmental factors, allergens, or stress. […] Genes may play at least some role in causing dyshidrotic eczema since you are more likely to experience dyshidrotic eczema if you have family members with the condition or another type of eczema. […] High levels of stress may contribute to having a dyshidrotic eczema flare. […] UV rays and hot, humid weather can cause dyshidrotic eczema for a number of reasons. […] Some cases of dyshidrotic eczema appear to be related to seasonal allergies.
- #41https://uihealthcare.adam.com/content.aspx?productid=117&pid=1&gid=000832
Pompholyx eczema is a condition in which small blisters develop on the hands and feet. The cause is unknown. The condition seems to appear during certain times of the year. […] You are more likely to develop pompholyx eczema when: […] Women seem to be more prone to developing the condition more than men are.
- #42 FloridaHealthFinder | Pompholyx eczema | Health Encyclopedia | FloridaHealthFinderhttps://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/000832
Pompholyx eczema is a condition in which small blisters develop on the hands and feet. The cause is unknown. The condition seems to appear during certain times of the year. […] You are more likely to develop pompholyx eczema when: You are under stress, You have allergies, such as hay fever, You have dermatitis elsewhere, Your hands are often in water or are moist, You work with cement or do other work that exposes your hands to chromium, cobalt, or nickel. […] Women seem to be more prone to developing the condition more than men are.
- #43 Dyshidrotic Eczema (Dyshidrosis): Symptoms, Causes, Treatmentshttps://my.clevelandclinic.org/health/diseases/17728-dyshidrotic-eczema
Dyshidrotic eczema is a common skin condition that causes blisters and itchy skin. Healthcare providers aren’t sure what causes dyshidrotic eczema. Triggers may include allergies, stress and frequently moist or sweaty hands and feet. […] Healthcare workers and researchers don’t know exactly what causes dyshidrosis. A combination of triggers can cause dyshidrosis flare-ups, including: […] Exposure to certain substances, including cement, nickel, cobalt and chromium, may trigger dyshidrotic eczema. Other allergies, including hay fever (allergic rhinitis) or food allergies, may also cause flare-ups. […] About 50% of dyshidrotic eczema cases occur in people who have allergic reactions when they touch an antigen. Researchers think that females may be more likely to develop dyshidrotic eczema because they more frequently interact with certain antigens, like nickel and cobalt in jewelry.
- #44https://www.eczemalife.com/pages/pompholyx-eczema-dyshidrotic
Pompholyx eczema is also called dyshidrotic eczema and the main symptom is blistering which can occur on the hands and feet. […] Contributing factors that can aggravate or trigger this form of eczema include emotional tension or stress, Poor diet and nutritional deficiencies, sensitivity to metal compounds (i.e. nickel, cobalt and chromate), exposure to heat, and […] It was once thought that sweating and disordered sweat glands caused this condition but that has since been disproven ( Calle Sarmiento, 2020). […] Pompholyx eczema accounts for 5-20% of all cases of hand eczema (Agner, 2015).
- #45 Dyshidrotic Eczema (Pompholyx) Treatment Cream Optionshttps://miiskin.com/skin-conditions/dyshidrotic-eczema-treatment-cream/
Dyshidrotic eczema, also known as dyshidrosis or pompholyx, is a type of eczema that causes small, itchy blisters on the edges of the fingers, toes, palms of the hands, and soles of the feet. These blisters are often filled with fluid and can be quite uncomfortable. […] However, the exact cause of dyshidrotic eczema is not fully understood, it is believed to be triggered by stress, allergies, moist hands and feet, and exposure to certain metals like nickel or cobalt. There also may be a genetic component to it, as it sometimes runs in families. […] Dr. Fernandez says that although stress is a significant trigger for dyshidrotic eczema, it is not the sole cause. This skin condition likely results from a combination of factors, including genetics, allergies, irritants, moisture, diet, infections, and seasonal changes. […] Although the exact cause is unknown, factors such as stress, allergies, moisture on the hands and feet, and exposure to certain metals (nickel and cobalt) are believed to trigger dyshidrosis.
- #46 Pompholyx (dyshidrotic eczema) | Health Information from Hedgegrail Pharmacyhttps://hedgegrailpharmacy.co.uk/nhs_conditions_pompholyx
Pompholyx (also called dyshidrotic eczema) is a type of eczema that affects the hands or feet. It’s not clear exactly what causes pompholyx. Certain things are thought to cause symptoms in some people, including: contact with strong chemicals like soaps, cleansers and detergents, an allergy or sensitivity to certain metals, such as nickel or cobalt, getting your hands wet regularly for example, if you’re a hairdresser, stress, heat and sweat. […] If you notice something causes your symptoms, avoiding it as much as possible may help keep your symptoms under control.
- #47 Acute palmoplantar eczema (dyshidrotic eczema) – UpToDatehttps://www.uptodate.com/contents/acute-palmoplantar-eczema-dyshidrotic-eczema
Acute palmoplantar eczema (more popularly known as dyshidrotic eczema or pompholyx) is an intensely pruritic, vesicular eruption affecting the palms, soles, or both. It is characterized by deep-seated lesions ranging from small vesicles to large, tense bullae clinically and by spongiotic vesicles histologically. Recurrence is common, and patients typically experience frequent episodes for months or years. […] This topic will discuss the pathogenesis, clinical presentation, diagnosis, and management of dyshidrotic eczema.
- #48 Dyshidrotic Eczema: Difficulty of Etiological Diagnosis and Therapeutic Managementhttps://clinmedjournals.org/articles/cmil/cmil-7-176.php?jid=cmil
However, DE is not related to any abnormality of the sweat glands. […] A skin biopsy is rarely required and is usually indicated when there is a lack of improvement with treatment or if an infection is indicated in the differential diagnosis. […] Spongiosis is the main pathologic finding. […] DE treatment is considered refractory when there is a lack of improvement after two to four weeks of adequate therapy.