Dyshidrotic Eczema

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Images of Dermatitis, Dyshidrotic

Overview

Dyshidrotic eczema (dyshidrotic dermatitis) is an itchy rash that appears as small fluid-filled blisters on the hands and feet. It is not known what causes dyshidrotic eczema. Sweating does not seem to cause the condition, although the term "dyshidrotic" refers to abnormal sweating. The lesions of dyshidrotic dermatitis are extremely itchy, and the condition often comes and goes (episodic), with episodes being more common in warm weather.

Who's at risk?

Dyshidrotic dermatitis is rare in younger children. When children do get the condition, it usually occurs after the age of 10.

Signs and Symptoms

The most common location of dyshidrotic eczema is on the hands, and it is less commonly seen on the feet.

Small, tense, clear, fluid-filled blisters appear on the surfaces of both palms and both soles (bilateral surfaces) and on 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 episodes, lesions can joint together (become confluent) and look like large blisters. If redness is present, it is mild.

Self-Care Guidelines

Help your child with the following:

  • Avoid exposure to harsh or aggravating materials (irritants).
  • Wash hands with mild soaps and cleansers, and frequently apply thick skin-softening (emollient) creams and petrolatum (such as Vaseline®).
  • Apply over-the-counter 1% hydrocortisone cream twice daily to help reduce itching.
  • Expose the hands and feet to sunlight (but not so long as to burn the skin) to help suppress symptoms.

When to Seek Medical Care

See your child's doctor for evaluation if he or she has a rash on the hands and/or feet that does not improve with self-care measures.

Treatments Your Physician May Prescribe

  • Soak with drying agents if many blisters are present.
  • Remove substances that are causing the symptoms (irritating agents).
  • Prescribe a medium- or high-potency topical steroid to be used twice daily. Applying a high-potency topical steroid at first and then tapering off gradually may be the most effective treatment.
  • Ultraviolet light treatment or antibiotics may be tried.

Trusted Links

Clinical Information and Differential Diagnosis of Dermatitis, Dyshidrotic

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.