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Therapeutics in Dermatology
A reference textbook in dermatology
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Dyshidrosis

29 August 2012, by LACHAPELLE J.-M. & SORIA A.

DEFINITION

Dyshidrosis is a type of eczema that affects the hands and feet, especially the palms and soles. It is usually characterized by the formation of blisters on the palms and/or soles and on the sides of the fingers; these blisters cause intense itching and may be accompanied by erythema (redness). Small blisters may merge together to form large blisters, eventually forming erosions that can become infected.

CAUSE

The cause of dyshidrosis is not known. It affects women and men equally and can also occur in children.

Excessive sweating and humid environments can provoke the condition and repeated contact of the skin with certain products like cosmetics, metals or perfumes can aggravate it. In such cases, allergy testing with patch tests can be proposed.

Mycologic cultures can also be performed to rule out a fungal infection.

COURSE

Dyshidrosis can be acute, but some cases are chronic and recurrent.

It is often a chronic, highly debilitating condition due to its recurrent nature and the intense itching it causes, and it can have a negative impact on the patient’s social and occupational activities.

TREATMENTS

Treatment usually consists of topical medications in association with lifestyle measures to avoid/eliminate causative factors.

— The main topical treatments are cortisone creams and ointments or topical immunomodulating agents (calcineurin inhibitors). Other treatments may be added on, particularly local PUVA therapy. 

— Controlling causative factors such as irritants and prolonged contact with water or moisture is a very important part of treatment. Treatments that minimize excessive sweating can also be used (ionophoresis, intradermal botulinum toxin injections, which may be painful).

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