Dyshidrotic eczema

Last Updated: 2022-03-25

Author(s): Anzengruber F., Navarini A.

ICD11: EA85.0

Hutchinson, 1875.

Dyshidrosis, dyshidrotic eczema, dyshidrotic hand eczema, dyshidrotic hand and foot eczema, dyshidrotic foot eczema, dyshidrotic hand eczema, dyshidrotic hand and foot eczema,


Intraepidermal vesiculosis and bullous variant of hand eczema

  • Occurrence mostly in the young middle aged persons.
  • Higher prevalence in warm, humid climates (summer).

  • Idiopathic.
  • Atopic diathesis (very often).
  • Contact allergy (often nickel or cobalt).
  • Hyperergic reaction (Id reaction) in mycosis.
  • Hyperhidrosis (some authors deny the association, the majority do not).
  • Psychogenic as a result of stress reactions.
  • Tobacco abuse is associated with exacerbation.
  • Administration of intravenous immunoglobulins.
  • UV exposure (case series with 5 patients, but light therapy is used as therapy).

  • Pruriginous, often symmetrically arranged, pin-sized, eruptive, grouped, water-clear, pruriginous vesicles and bullae palmoplantar, in particular it can come to an intensified occurrence at the finger edges.
  • The backs of the hands and fingers show erythematous, pruritic, sometimes disseminated papules and vesicles
  • When there are pronounced blisters on the edges of the fingers, this is referred to as a pompholyx.
  • Often patients describe ↑ tendency to sweat.
  • Variants of dyshidrosis:
    • Cheiropompholyx and podopompholyx: maximum variant
    • Dyshidrosis lamellosa sicca (exfoliatio manuum areata): The vesicles dry up quickly, resulting in a ruff-like scaling.

  • Anamnesis with regard to aetiologically significant factors (atopy, contact allergies, hyperhidrosis, psychological stressors)
  • Mycology, if suspicion exists.
  • Epicutaneous testing, if contact allergy is suspected.
  • Atopy screening (total IgE).

Palmoplantar. Predilection sites are the interdigital spaces (transition between groin skin and field skin).

The picture is one of acute allergic contact dermatitis with spongiotic blistering, acrosyringia, perivascular, lymphocytic infiltrates in the stratum papillare stratum reticulare.

  • Superinfection.
  • Gram-negative forefoot infection.

Frequent recurrences.

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