Dyshidrotic dermatitis in Child
Alerts and Notices
Synopsis
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.
Codes
ICD10CM:L30.1 – Dyshidrosis [pompholyx]
SNOMEDCT:
201201000 – Podopompholyx
402222007 – Vesicular hand eczema
Look For
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Diagnostic Pearls
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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
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Management Pearls
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Therapy
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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
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Last Reviewed:12/16/2020
Last Updated:01/17/2021
Last Updated:01/17/2021
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Dyshidrotic dermatitis in Child