Dyshidrotic eczema (DE) is a type of chronic, relapsing dermatitis characterized by the development of clear vesicles on the palms and soles. The condition typically affects adults aged 20-40 years old, with women being affected more often than men. While DE can be a nuisance due to its recurrent nature and potential for causing pain and disability, it is not generally associated with serious health complications.
The exact cause of DE is unknown but appears to involve an abnormality in the way that skin cells function. This may be due to genetic factors or underlying medical conditions such as allergies or autoimmune disorders. Exposure to irritants such as metals or chemicals has also been linked to the development of DE lesions.
The most distinguishing feature of DE is the presence of small blisters (vesicles) on the palms and/or soles which are usually itchy or painful (Figure 1). These blisters typically last 3-4 weeks before healing without scarring; however, new crops may continue to develop during this time leading to prolonged symptoms lasting several months. In some cases, secondary bacterial infection can occur resulting in crusting and weeping ulcers which prolongs healing time even further.
While DE can be a frustrating condition to deal with, there are several treatment options available which can help to control symptoms and promote healing. Topical corticosteroids are often effective in reducing inflammation and itchiness associated with the blisters. Antihistamines may also be used to relieve itching while oral steroids may be necessary for more severe cases unresponsive to other treatments. Ultraviolet light therapy (phototherapy) has also been shown to be helpful in some patients. In addition, avoiding triggers such as contact irritants or excessive heat/sweating is important in preventing future flare-ups of DE lesions.