As displayed in this image, the blisters of dyshidrotic dermatitis are often difficult to see due to the thick skin of the palm and fingers.    This image displays deep-appearing blisters typical of dyshidrotic dermatitis. This image displays blisters on the foot of a patient with dyshidrotic dermatitis, which can affect the feet as well as hands. Dyshidrotic dermatitis typically causes small, clear fluid blisters at the sides of the fingers, as displayed in the image. This image displays a severe example of dyshidrotic dermatitis on the palms. This image displays a typical case of dyshidrotic dermatitis on the fingers.
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Dyshidrotic Eczema  Teen information

Picture of Dyshidrotic Eczema: As displayed in this image, the blisters of dyshidrotic dermatitis are often difficult to see due to the thick skin of the palm and fingers.    Divider line
As displayed in this image, the blisters of dyshidrotic dermatitis are often difficult to see due to the thick skin of the palm and fingers.
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Overview
Dyshidrotic eczema, also known as dyshidrotic dermatitis, is an itchy rash that occurs on the hands and feet. Dyshidrotic eczema looks like blisters on the skin. Sometimes the blisters are very small, like pinpoints, and sometimes they are larger, covering almost the whole palm or foot. The fluid inside the blister can be clear or white to yellow. It is not known what causes this condition, but it is more common in people with eczema; even in people without sensitive skin, it seems to be triggered by the same things that trigger eczema: cold, dry air or contact with irritants that bother the skin. In other people, a warm, moist climate may be the trigger. Do not pop the blisters of dyshidrotic eczema because of the risk of infection. A doctor may prescribe a cream to help the rash heal.
Who's At Risk
Anyone of any age can develop dyshidrotic eczema, but it is usually seen in teens and adults and rarely in infants and children.
Signs and Symptoms
The most common location of dyshidrotic eczema is on the hands and less commonly the feet.
  • Small, tense, clear fluid-filled blisters are seen on the surfaces of palms and soles and the sides of the fingers and toes.
  • These blisters can appear "deep-seated" (tapioca-like) due to the thickness of the skin on the palms. In severe cases, individual blisters can merge together and present as large blisters (bullae).
  • Redness (erythema) is typically mild or absent.
Self-Care Guidelines
Avoidance of irritants may be helpful.
  • Handwashing with mild soaps and cleansers and frequent application of thick emollient creams and petroleum jelly may be beneficial.
When to Seek Medical Care
Seek medical evaluation for a rash on the hands and/or feet that is unresponsive to self-care measures.
Treatments Your Physician May Prescribe
To manage dyshidrotic eczema, your physician may recommend removal of irritating agents and, if many blisters are present, soaks with drying agents.
  • Medium- and high-potency topical steroids may be prescribed to be used twice daily. Use of a high-potency topical steroid initially that is tapered as allowed may be most beneficial.
  • An oral steroid (prednisone) may be necessary but people often cannot be tapered off this therapy.
  • Chronic, severe disease can be treated with a form of light therapy called PUVA (psoralen and ultraviolet A phototherapy) administered by a dermatologist.

References

Bolognia, Jean L., ed. Dermatology, pp.582. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.32. New York: McGraw-Hill, 2003.
Last Updated: 22 Dec 2008