Dyshidrotic Eczema
Dyshidrotic eczema is a chronic, recurring type of eczema that affects the hands and feet. Small, clear bubble-like vesicles appear in these regions during an episode and tend to be symmetrically distributed. While the palms and soles are most heavily involved, vesicles may also appear on the sides of fingers or toes. In about 80 percent of patients, only the hands are affected. In ten percent, only the feet are affected. In the remainder, both hands and feet are affected.
Males and females are equally likely to develop dyshidrotic eczema, and while the condition is more common in middle-aged people, people in other age groups may be affected too. In the United States, up to 20 percent of all people with eczema affecting the hands may have dyshidrotic eczema. The condition tends to occur more frequently in areas with a warmer climate.
Contrary to popular belief, dyshidrotic eczema appears to be unrelated to the sweat glands. The exact cause of dyshidrotic eczema is unknown, but several factors are thought to contribute. Many people with this type of eczema also have a history of atopic eczema or some other allergic condition, such as hay fever. Fungal, bacterial or other infections, and intravenous administration of immunoglobulins may also trigger an episode. Contact with certain compounds, such as nickel, may play a role and should be suspected if a person develops symptoms after exposure to costume jewelry or comes into contact with such compounds at work or during leisure activities. Dyshidrotic eczema has been linked to extreme emotional stress.
In most patients, dyshidrotic eczema resolves spontaneously in two to three weeks. In the remainder, corticosteroid creams and anti-itching creams may offer relief. In some cases, vesicles merge together to form a larger lesion, which may require drainage or aluminum acetate compresses. An antibiotic may be prescribed to prevent bacterial infection. In more severe cases, oral steroids or botulinum injections may be prescribed.
