Pompholyx - Definition, Causes, Symptoms and Treatment

Definition

Pompholyx is a common type of eczema affecting the hands, and sometimes the feet. It is also known as dyshidrotic eczema or vesicular eczema of the hands and feet. Pompholyx is a form of hand eczema more common in women which starts on the sides of the fingers as itchy little bumps and then develops into a rash. The word dyshidrotic is used because it is felt that this condition is related to sweat glands, but this association has not been proven. It is a very distinctive form of eczema, characterised initially by an eruption of very itchy vesicles on the sides of the fingers and palms of the hands. The female-to-male ratio is 2:1. Peak incidence occurs in patients aged 20-40 years, although the disorder also occurs in teenagers and older patients. Pompholyx has no associated mortality, although some severe cases can become debilitating.

Causes

1. The exact cause of pompholyx is unknown. Yet some conditions are there which are believed to contribute in this disease.
2. Some investigators consider it is caused by abnormal sweating. Pompholyx is aggravated by contact with irritants such as water, detergents and solvents. Contact with them must be avoided as much as possible.
3. It may be caused by fungal infection.
4. Contact dermatitis is also believed to lead to cause this disease.
5. Some ingested substances such as nickel, chromium, and cobalt. It is more common among adolescents and young adults.
6. Extra mental stress may also cause this disease.
7. Some risk factors are difficulty expressing feelings or emotions, hot or cold temperatures, recent immunoglobulin therapy or seasonal changes etc.

Symptoms

1. There may be intense itching at the site of the blistering.
2. There may appear cracks or fissures on the fingers or toes.
3. Blisters are opaque and deep-seated; they are either flush with the skin or slightly elevated and do not break easily. Eventually, small blisters come together and form large blisters.
4. Scratching blisters breaks them, releasing the fluid inside, causing the skin to crust and eventually crack. This cracking is painful as well as unsightly and often takes weeks, or even months to heal.
5. This skin disorder will usually clear up after two weeks. Some individuals could experience mostly one stage of the aliment or the other, and sometimes both at the same time.

Treatment

1. Soaks or compresses using weak solutions of potassium permanganate, aluminium acetate, or vinegar in water are applied for 15 minutes four times a day to dry up the blisters.
2. Topical steroids should be applied to the affected areas nightly. They help reduce inflammation and itching.
3. Antibiotics such as flucloxacillin should be prescribed by your doctor for secondary infection.
4. Avoid anything that irritates the skin and wear cotton gloves inside vinyl gloves when doing dishes or other wet chores.
5. PUVA therapy can be useful in selected cases. This is a special kind of ultraviolet treatment and used generally to cure this disease.
6. Moisturizing cream also helps in curing this disease.