Dyshidrotic dermatitis (dyshidrotic eczema, pompholyx) is generally defined as a recurrent vesicular eruption limited to the hands (most often the sides of the digits) and sometimes the feet. The lesions are extremely pruritic. The etiology is unknown; no causal relationship with sweating has been shown. There is no sex predilection.
Dyshidrotic dermatitis is rare in younger children. When arising in the pediatric population, it is generally seen after the age of 10. The condition often presents episodically, more commonly in warm weather.
Dyshidrotic eczema has been associated with atopic dermatitis, contact irritants and allergens, dermatophyte and bacterial infections, hyperhidrosis, hot weather, diet, and emotional stress. Administration of intravenous immunoglobulin (IVIG) has been associated with severe dyshidrotic dermatitis. There have also been a few reports of dyshidrotic dermatitis in adults treated with secukinumab.
Some cases spontaneously resolve. Treatment is aimed at symptomatic relief and control of vesiculation.
Dyshidrotic dermatitis in Child
Alerts and Notices
Important News & Links
Synopsis
Codes
ICD10CM:
L30.1 – Dyshidrosis [pompholyx]
SNOMEDCT:
201201000 – Podopompholyx
402222007 – Vesicular hand eczema
L30.1 – Dyshidrosis [pompholyx]
SNOMEDCT:
201201000 – Podopompholyx
402222007 – Vesicular hand eczema
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Allergic contact dermatitis – Distinguishing idiopathic dyshidrotic dermatitis from allergic contact dermatitis can be difficult, although contact dermatitis often involves the dorsum of the hand. An extensive history of environmental exposure should be gathered when a vesicular hand rash is present.
- Palmoplantar pustulosis
- Dermatophyte infection (eg, tinea pedis and/or manuum)
- Herpetic whitlow
- Pustular psoriasis
- Bullous impetigo
- Infantile acropustulosis
- Scabies is associated with superficial vesicles, pustules, and burrows; often has coexistent lesions on the wrists, waist, and axillae; and is diffusely pruritic.
- In immunocompromised patients, also consider crusted scabies.
- Epidermolysis bullosa simplex
- Hand-foot-and-mouth disease – Causes oval, palmoplantar vesicles as well as concomitant oral mucosal vesicles or erosions.
- Zoster
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
Subscription Required
References
Subscription Required
Last Reviewed:12/16/2020
Last Updated:01/17/2021
Last Updated:01/17/2021
Patient Information for Dyshidrotic dermatitis in Child
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
- Improve treatment compliance
- Reduce after-hours questions
- Increase patient engagement and satisfaction
- Written in clear, easy-to-understand language. No confusing jargon.
- Available in English and Spanish
- Print out or email directly to your patient
Upgrade Today
Dyshidrotic dermatitis in Child