Dyshidrosis is also called as dyshidrotic eczema or pompholyx. In this condition, small fluid-filled blisters develop over the skin of the hands or feet, especially on the fingers, palms and soles. These blisters are small and itchy. This condition is more common in adults between 20 to 30 years of age, and is more commonly seen in women than in men. These blisters come and go over time and there is no known cure for this condition. However, the blisters can be managed by the optimal skin care and medications.
SIGNS AND SYMPTOMS
The following are the signs and symptoms of dyshidrosis:
- Small fluid-filled blisters on the fingers, hands, and feet. These blisters may merge to form a large blister
- Scaly, cracked skin
- Skin peeling
- Itchy skin
The exact cause of dyshidrosis unknown. The following are certain triggers of dyshidrosis:
- Intravenous immunoglobulin infusions
- Certain chemicals used in perfumes
- Seasonal allergies like hay fever
- Exposure to metals such as nickel or cobalt
- An antibiotic called neomycin
- Fungal infection of the skin
- Emotional stress
- Humid weather
The exposure of skin to irritants such as detergents, chemicals and water may worsen the condition.
The risk factors for dyshidrosis are as follows:
- Atopic eczema
- Family history of allergies such as hay fever
- Sensitive skin
- Intense itching may cause skin damage leading to bacterial infection of the skin.
- Severe pain or itching caused by blisters may cause sleep disturbances.
- Pain and itching from blisters may limit the use of affected hands or feet.
In general, diagnosis of dyshidrosis is made clinically and do not require any investigations.
The following investigations are done to rule out other conditions that may have caused blisters such as infection or allergies:
Culture and sensitivity tests: In this test, a sample of the blister fluid is cultured in a predetermined culture media under favorable conditions. This help in detecting the presence of skin infection.
Punch biopsy: It is a low risk medical procedure and done under local anesthesia. The doctor may remove a small piece of the affected skin using a tube-shaped tool. The obtained specimen is sent to a laboratory for microscopic and histopathological examinations.
Patch test: In this procedure, special metal discs with different allergens are taped on to the skin. The doctor checks for the allergic reactions 48 hours later.
The doctor may plan the treatment based on the severity of signs and symptoms.
- Antihistamines: Drugs such as Benadryl can be prescribed for mild outbreak of dyshidrosis to decrease your symptoms.
- Corticosteroids: Corticosteroids are anti-inflammatory drugs. Blisters may be effectively treated with creams and lotion containing corticosteroids.
- Phototherapy: This therapy involves the use of ultraviolet(UV) light and drugs that make the skin more sensitive to UVlight.
- Immune-suppressing ointments: Immune-suppressing ointments such as tacrolimus and pimecrolimus may be prescribed in addition to corticosteroids to reduce the dosage and side effects of corticosteroids.
- Botulinum toxin injections: In severe dyshidrosis, the doctor may prescribe botulinum toxin injections.
- Application of wet and cool compress may reduce itching.
- Witch hazel is a plant, soaking the affected areas with it may help to relieve symptoms faster.
- Moisturizing the skin with thick lotions and petroleum jelly.
The following measures are useful to prevent dyshidrosis:
- Applying moisturizers daily
- Leading a stress-free life
- Avoiding triggers of dyshidrosis
- Staying hydrated to prevent dry skin