Dyshidrosis

Dyshidrosis is a type of dermatitis that is characterized by itchy blisters on the palms of the hands and bottoms of the feet. Blisters are generally one to two millimeters in size and heal over three weeks. However, they often recur. Redness is not usually present. Repeated attacks may result in fissures and skin thickening. The cause is unknown. Triggers may include allergens, physical or mental stress, frequent hand washing, or metals. Diagnosis is typically based on what it looks like and the symptoms. Allergy testing and culture may be done to rule out other problems. Other conditions that produce similar symptoms include pustular psoriasis and scabies. Avoiding triggers may be useful, as may a barrier cream. Treatment is generally with steroid cream. High strength steroid creams may be required for the first week or two. Antihistamines may be used to help with the itch. If this is not effective steroid pills, tacrolimus, or psoralen plus ultraviolet A (PUVA) may be tried. About 1 in 2,000 people are affected in Sweden. Males and females appear to be affected equally. It explains about one in five cases of hand dermatitis. The first description was in 1873. The name comes from the word "dyshidrotic", meaning "difficult sweating", as problems with sweating was once believed to be the cause. Dyshidrosis has been described as having the following characteristics: Itchiness of the palms or soles, followed by the sudden development of intensely itchy small blisters on the sides of the fingers, the palms or the feet. These blisters are often described as having a "tapioca pudding" appearance. After a few weeks, the small blisters eventually disappear as the top layer of skin falls off. These eruptions do not occur elsewhere on the body. The eruptions may be symmetrical. File:DyshidroticDermatitisOnHandsLateStage.jpg|Advanced stage of dyshidrosis on the fingers File:Dyshidrosis.JPG|Palmar dyshidrosis File:Palmar dyshidrosis peeling stage.JPG|Advanced stage of palmar dyshidrosis on the palm showing cracked and peeling skin File:Dyshidrosis late stage.