Table of Contents
What Is Dyshidrosis?
Dyshidrosis is a condition characterized by blisters on the skin that cause excessive itching and usually last for 3 weeks. It is often seen on the soles of the feet and the palms. After the dyshidrosis blisters dry, the skin may appear scaly, and they tend to recur before the skin fully heals from the previous blisters.
Doctors call this pompholyx or dyshidrotic eczema. These itchy, painful blisters were first described in 1873 and were related to our sweating pattern. However, the current study shows that this type of eczema is associated with the body's immune response.
What Are the Symptoms of Dyshidrosis?
Blisters are most frequently found over the palms and on the sides of the fingers, though they can also affect the soles of the feet. The blisters are usually small, grouped in clusters, and resemble tapioca. In severe cases, a few small blisters can merge to form a larger blister. It can be painful and very itchy, and it dries and flakes off in about 3 weeks. Most of the time, they recur fairly regularly for months or years, and especially get infected if the skin is scratched.
They usually pop up in clusters, and they can also have;
- Red cracked skin.
- Sweaty skin around the blisters.
- Nails become thick and change their color.
- Itching and burning sensation around the blisters.
The actual cause of dyshidrotic eczema is unknown; it usually affects adults between the ages of 20 and 40, and it is twice as common in women as in men. It occurs mostly in immunocompromised patients who are very allergic to hay fever and have a family history. Also, if you have a family history of skin issues or have any allergic problems, the chances of this are very high. According to studies, almost 20 percent of people with hand eczema have this issue.
It includes various risk factors:
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Exposure to Certain Metals:
This includes cobalt, nickel, or chromium salts, which are usually found in industrial settings or in items like costume jewelry.
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Stress:
It is found to be more common during mental and physical stress.
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Sensitive Skin:
People who are in contact with the infected person are more prone to dyshidrosis.
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Atopic Dermatitis:
Some people with psoriasis (a chronic, non-contagious autoimmune condition) and atopic dermatitis may develop dyshidrotic eczema.
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Warm Humid Weather:
Warm, humid weather exacerbates skin conditions by causing excessive sweating in a particular region.
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HIV Infection:
Dyshidrosis is one of the symptoms of HIV infection.
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Seasonal Allergies:
Seasonal allergies also cause tiny bumps on the skin, similar to an infection.
What Are the Complications of Dyshidrosis?
Persistent dyshidrosis can lead to localized complications. Scratching the blister sites can lead to bacterial infection. In severe cases, it may turn into cellulitis. Sometimes the rash persists for a long time and does not go away. Also, pain and itching can limit the use of the hand or that particular body part.
How Is Dyshidrosis Diagnosed?
This condition is caused mostly by an allergy, according to a dermatologist. A patch test may be recommended with that allergic substance. The allergen is applied to the back of the skin to determine whether there is a reaction. If the dermatologist finds some allergic reactions, the doctor will:
- Observe the affected area of the hand and feet closely.
- Take a bit of fluid from the blisters if they look infected.
- Ask about the health, the job, and the history of noticing these blisters.
- Ask about the history of smoking.
- Whether the patient had an injection of Vitamin B12.
- Worked with cutting oil or cement.
- Take any medication, which includes Aspirin or birth control pills.
- During treatment, be sure to confirm the confirmation provided to the dermatologist and mention whether any metal implant procedures have been performed.
How Do Dermatologists Treat Dyshidrosis?
The dermatologist will choose a course of therapy based on the severity of the problem. The following are the treatment options for dyshidrosis:
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Soaks and Cool Compress:
Medication and cool compression can be very effective for drying blisters, which should be applied two to four times in 24 hours.
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Application of Corticosteroids:
After cooling the area and applying medication, apply a cream or ointment containing a corticosteroid; this helps reduce inflammation and clear the skin.
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Anti-itching Medicine:
Antihistamine pills or other anti-itching medicines such as Fexofenadine or Cetirizine can reduce discomfort. Scratching can increase your discomfort. Topical corticosteroids such as Hydrocortisone can relieve your discomfort early.
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Application of a Moisturizer or a Barrier Repair Cream:
Dyshidrotic eczema can make the skin extremely dry and prone to flare-ups, which can be reduced with a dermatologist-prescribed barrier-repair moisturizer.
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Medication to Treat an Infection:
Dyshidrotic eczema can itch intensely, and frequent scratching can lead to infection. To treat the infection, the dermatologist will first analyze the type of infection and then prescribe medication, such as a Botulinum toxin injection, to treat the infected area.
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Stronger Medication:
Studies show that people who are likely to have this hypersensitivity and who experience flare-ups that cause blisters are treated with corticosteroids. Still, some patients need stronger medication, such as a nonsteroidal immunomodulating agent, Tacrolimus. They are meant to strengthen the immune system and can be given for a few weeks. Also, a doctor can prescribe you Pimecrolimus to treat other eczematous conditions.
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Light Treatments:
This is the option when stronger treatment is required and takes at least three weeks. Do not try to self-treat by spending long hours outdoors without sun protection or using a tanning bed; this can increase the risk of skin cancer.
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Systemic Medicines:
If the condition is serious or you are suffering from extreme dyshidrosis or eczema, the doctor can give you oral medicines like Dapsone and Thalidomide. These immunosuppressive medicine agents not only cure dyshidrosis but also address associated skin issues. Also, they can use other medicines like Cyclosporine or Methotrexate.
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Changes in Diet:
If hypersensitivity to cobalt and nickel is present, a dietary change may reduce flare-ups. A proper diet chart is prescribed by the doctor to avoid all foods that contain metal. The higher the nickel content, the higher the point value of that food or beverage.
Conclusion
Dyshidrosis appears as small blisters in your palms and soles. When these small blisters heal, they can cause an itchy, burning sensation. As this is an eczematous lesion, a history of allergy, metal contact, or weather change can trigger this. Along with medicines like corticosteroids, simple steps such as cold compression and moisturizers can cure it. For any queries about dyshidrosis, you can speak with a skin care specialist for a proper evaluation.
Key Takeaways
- Dyshidrosis is a type of eczema that affects your palms and soles.
- Dyshidrosis causes small blisters and skin peeling during healing.
- Dyshidrosis is associated with contact dermatitis and allergic reactions.
- Topical corticosteroids or antihistamine drugs can help manage it.
