Dyshidrotic Dermatitis (aka Hand & Foot Eczema): Facts and Factors

This common eczema, which occurs only on the palms of the hands, sides of the fingers, and soles of the feet, typically causes a burning or itching sensation and a blistering rash. Some patients say the blisters resemble tapioca pudding.

Other Names

• Hand eczema
• Pompholyx
• Vesicular eczema
• Vesicular palmoplantar eczema

Signs and Symptoms

• Small, deep blisters can form on the palms, sides of the fingers, and/or soles
• Intense burning or itching
• Inflamed skin (reddish and hot to the touch)
• Cracking and peeling skin
• Affected areas may sweat excessively.
• Skin may become infected, causing oozing blisters and crusts.
• Skin between the fingers can soften; skin may feel spongy.
• Nail changes if dyshidrotic dermatitis persists for a long time. The fingernails can develop ridges and pitting. The nails may thicken and discolor.
• Sometimes as the skin clears, the skin peels and a new crop of blisters appear.
• Extensive peeling and cracking in severe cases

• Unknown
• Researchers now believe that a person’s reaction to events occurring within the body (e.g., having another medical condition) and factors occurring outside the body (e.g., the weather) play a role.
• Research shows that excessive sweating—originally believed to be the cause—does not cause dyshidrotic dermatitis.

Risk Factors

Researchers have identified several factors that can increase one’s risk of developing dyshidrotic dermatitis and the risk of flare-ups:

• Stress. Probably the most common risk factor, many patients report a stressful period before an outbreak

• Gender. Females tend to develop dyshidrotic dermatitis more frequently than males.

• Weather. Flare-ups are most frequent in hot humid weather. In fact, the weather is a common trigger for many patients. A study of 104 patients found that the following weather conditions triggered flare-ups: heat (29.8% of patients), humidity (24% of patients), and cold (12.5% of patients).

• Pre-existing atopic condition (e.g., atopic eczema, hay fever, or asthma). Having one or more of these conditions significantly increases the risk.

• Pre-existing contact dermatitis. Having contact dermatitis significantly increases the risk of developing dyshidrotic dermatitis. Contact with everyday objects—from shampoo and jewelry to food and water—causes contact dermatitis. When the contact leads to irritated skin, the eczema is called irritant contact dermatitis. If an allergic reaction develops on the skin after exposure, the eczema is called allergic contact dermatitis.

• Pre-existing infection. Having an infection in another part of the body may increase the risk. A study found that one-third of the patients saw the dyshidrotic dermatitis on their hands clear after they received treatment for their athlete’s foot.

• Metal implant, such as a hip replacement. Studies show a direct correlation between a metal allergy and developing dyshidrotic dermatitis.

• Aspirin, oral contraceptives, and smoking. One study suggests that smoking as well as taking aspirin or an oral contraceptive increases the risk.

Source: American Academy of Dermatology