Dyshidrotic eczema is a common condition that is still poorly understood. In fact, there is as much confusion with its name(s) as with its etiology.
The condition is a type of eczema that is characterized by pruritic vesicles (itchy, tiny blisters) that erupt in the fingers, palms and sometimes feet. It affects both children and adults, and can range from a rare, self-limiting problem to a chronic, severe and sometimes debilitating one.
Unfortunately, it also tends to be resistant to many forms of treatment.
The term dyshidrotic refers to the hypothesis that sweat glands dysfunction and cause the tiny blisters. But when a research group did biopsies of the palms of affected patients they did not find a problem with the sweat glands. Yet, it is known that people with hyperhidrosis (super-sweaters) are very prone to the condition. Also, Botox injections which help people with hyperhidrosis in their arm pits also help hand/foot eczema if the Botox is administered there.
Two other names for the condition: pompholyx (which means “bubble”), or pedpompholyx (if the rash appears only on the feet); and also, acute and recurrent vesicular hand and foot dermatitis.
The tiny blisters itch intensely, then pop and cause the skin to peel. Over time the skin can become thickened and fissured. About 50% of persons with this condition also have allergic problems. Also shown is a strong familial tendency for the condition.
Certain metals if ingested can cause the problem; most common are nickel and cobalt. Websites can detail the metal content of various foods and beverages.
Emotional stress is a well-recognized aggravator of the misery, but episodes also can be precipitated by environmental factors such as changes in temperature and humidity.
Although resistant to therapies, most people benefit by intensive efforts to moisturize the hands. A simple therapy that often works is Vaseline petroleum jelly applied to the hands, and then covered with white cotton gloves at night.
A variety of OTC and prescription steroid creams, lotions and ointments are effective to speed healing.
Finally, soaking the hands in cool water for 10-15 minutes stops the itch and can re-hydrate the skin.