Dyshidrotic eczema

Description, Causes and Risk Factors:

Dyshidrotic eczema is a recurrent or chronic relapsing form of vesicular palmoplantar dermatitis of unknown etiology. Dyshidrotic eczema also is termed pompholyx, which derives from cheiropompholyx, which means "hand and bubble" in Greek.

The etiology of dyshidrotic eczema is unresolved and believed to be multifactorial. It is considered a reaction pattern caused by various endogenous conditions and exogenous factors.

Several hypotheses exist for the pathophysiology of dyshidrotic eczema. The original hypothesis of sweat gland dysfunction is not valid, since vesicular lesions are not associated with sweat ducts. Patients usually do not have hyperhidrosis. Dyshidrotic eczema may be associated with atopy. Of patients with dyshidrosis, one half have atopic dermatitis.

Exogenous factors (eg, contact dermatitis to nickel, balsam, cobalt; sensitivity to ingested metals; dermatophyte infection; bacterial infection) may trigger episodes. These antigens may act as haptens with a specific affinity for palmoplantar proteins of the stratum lucidum of the epidermis. The binding of these haptens to tissue receptor sites may initiate pompholyx.

Emotional stress and environmental factors (eg, seasonal changes, hot or cold temperatures, and humidity) reportedly exacerbate dyshidrosis.

Studies have shown that the condition affects males and females in equal ratio. In the US Dyshidrotic eczema occurs in as many as 5-20% of patients with hand eczema and more commonly occurs in warmer climates and during spring and summer months. It is a severe condition and patients may need to take several days off from work to recover from it. Although it is seen in patients as young as four years of age, the frequency of episodes increases in middle age.

Dyshidrotic eczema affects the hands and feet, either together or separately. By far the most common presentation, accounting for about 80% of cases is for the hands to be involved exclusively. The remaining 20% of cases will be equally divided amongst patients with involvement of either the feet alone, or the hands and feet together.

Symptoms:

Small fluid-filled blisters called vesicles appear on the fingers, hands, and feet. They are most common along theedges of the fingers, toes, palms, and soles. These blisters cause intense itching and scaly patches of skin that flakeconstantly or become red, cracked, and painful.Scratching leads to skin changes and skin thickening. Large blisters may cause pain.

Do not scratch the blisters. You should avoid frequent bathing, hand washing, and irritating substances, which can make itching worse.

Diagnosis:

Your doctor may be able to diagnose this condition by simply looking at your skin.Sometimes, a skin biopsy or skin scraping may be needed to rule out other causes, such as a fungal infection. If your doctor thinks the condition may be due to an allergic reaction, allergy testing (patch testing) may be done.

Treatment:

Scratching the hands when they itch only makes the condition worse. Yet scratching can be hard to stop.

Anti-itch medicines taken by mouth, such as diphenhydramine (Benadryl) and loratadine (such as Claritin), may help you break this cycle. If you scratch while asleep, take an anti-itch medicine before bed.

• Ointments or creams should be used on the hands at least two times per day, and after every hand washing.

• Heavy ointments are best. Petroleum jelly (such as Vaseline), mineral oil or vegetable shortening may be best but can be messy.

• Creams are better than lotions. Creams such as Eucerin and Lubriderm may be helpful.

• Your doctor may prescribe steroid (or corticosteroid) ointments creams, or other creams or ointments such as tacrolimus or pimecrolimus.

Your doctor may recommend the following if you have severe symptoms:

Steroid pills.

• Coal tar preparations.

• Phototherapy (ultraviolet light therapy).

Natural Treatment Options:

Mix oatmeal with honey 50/50. Mix it together and apply it to your eczema rash, then leave it for 30 minutes. After that time wash if off with lukewarm water. You'll notice this soothes and relives your flare up right away.

• Oatmeal baths - this is not a cream for eczema but an effective treatment! Grind oatmeal up until it's a fine powder and add it to a bath full of warm (but not too hot!) water. Lie in the water for 15 minutes before getting out, you'll notice right away that the itchiness has been relieved from your hands, feet and any other areas where you had an eczema rash/sore.

• Mix Oatmeal with egg whites to form a very rich exfoliating masque. Apply to your rash/rashes and wait for it to dry into the skin before washing off, you will notice it smoothes your skin and it feels softer to touch. This works great for facial eczema.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.