Pompholyx/ dyshidrotic eczema/ palmar eczema cause and treatment

Pompholyx is a stressful and itchy condition. This involves palm soles and small or large blisters appear on affected areas. These blisters usually start on the sides of fingers and toes. The most troublesome symptom of pompholyx is intense itching on palms and soles. These vesicles are mostly small and can appear in clusters. In some cases, pompholyx can happen in response to infections like fungal infections. The skin of involved areas in such cases can be painful, red and sensitive.

Causes and risk factors of Pompholyx

  1. Atopic eczema
  2. Exposure and allergy to nickel, cobalt and other metals
  3. Contact with irritants like detergents, solvents, acids, and friction
  4. Inflammatory reactions to fungal infections called Dermatophytid.
  5. Adverse reaction to immunoglobulin and certain other drugs.

Symptoms of pompholyx
Blisters in hands happen in 80%, feet in 20%, and 8% people show both hand and feet involvement. The most common initial symptom of pompholyx is small blisters on sides of fingers. In severe cases of pompholyx, these blisters later become coalesced and may involve entire palm and soles. Involved palms and soles tend to be painful and very itchy. Blisters tend to dry and the flake of over a period of about 3-6 wks leaving the underlying skin red and tender. A small episode of Pompholyx thus takes 6-8 wks for complete healing with proper care
Prevention of repeated episodes of pompholyx

General skin care principles for eczema which can help reduce episodes of Dyshidrosis are

  1. Use mild cleansers to wash hands
  2. Apply moisturizer regularly
  3. Wear gloves while working with exacerbating chemicals/ in kitchen/ using detergents
  4. Use barrier creams

Diagnosis of Dyshidrosis/ pompholyx
There are no lab tests to specifically confirm the diagnosis of Dyshidrosis; so usually, skin specialist or dermatologist diagnose pompholyx by physical examination.
Treatment of Pompholyx
Treatment of pompholyx or dyshidrotic eczema varies based on the severity of symptoms and episodes. Treatment may involve

following types of medications

  1. Topical creams to soothe, heal and control irritation
  2. Oral medications to control itch, infection or and immunosuppressive medication in severe cases.
  3. Phototherapy
  4. Botox injections
  5. Iontophoresis

Lifestyle modifications for pompholyx care

  1. Using medicated compresses as advised by the dermatologist
  2. Taking anti-itching medication
  3. Removal of contributing factors such as exposure to heat, chemicals, seat reduction, detergents.
  4. Reduction of emotional stress


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