Dyshidrotic eczema presents with small, tense blisters on the palms, sides of the fingers and soles of the feet. It runs in flares and is associated with intense itching. The name is historical; the condition has nothing to do with a disorder of the sweat glands.
Causes
An atopic predisposition is frequently present. Recognised triggers are contact allergies, particularly to nickel, as well as wet work, stress, heat, heavy sweating and fungal infections elsewhere on the body. In many cases no single trigger can be identified with certainty.
Symptoms
Characteristic are deep-seated, sago-like blisters that do not burst immediately. After a few days they dry up, the skin peels in a collar-like pattern and may crack painfully. The itching often precedes the visible rash.
Treatment
In an acute flare, drying compresses and anti-inflammatory preparations help. Afterwards, intensive emollient care is important to restore the barrier. In addition, possible triggers are investigated and avoided; in case of frequent relapses phototherapy or further treatments are an option.
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