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Dyshidrotic dermatitis in Adult
Other Resources UpToDate PubMed

Dyshidrotic dermatitis in Adult

Contributors: Jeffrey M. Cohen MD, William Schaffenburg MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

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 etiology is unknown; no causal relationship with sweating has been shown. There is no sex predilection. The lesions are extremely pruritic.

Dyshidrotic eczema can be associated with atopic dermatitis, contact irritants and allergens, dermatophyte and bacterial infections, hyperhidrosis, hot weather, high dietary intake of nickel or cobalt, 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 patients 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
  • Tinea corporis (eg, Tinea pedis and/or Tinea manus)
  • Herpetic whitlow
  • Pustular psoriasis
  • Bullous impetigo
  • Scabies
  • In immunocompromised patients, also consider Crusted scabies.
  • Epidermolysis bullosa simplex
  • Porphyria cutanea tarda
  • Hand, foot, and mouth disease
  • Herpes zoster
  • An unusual acral form of Bullous pemphigoid resembles dyshidrotic eczema.
  • Dyshidrotic Cutaneous T-cell lymphoma
  • Erythema multiforme

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.

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References

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Last Reviewed:12/16/2020
Last Updated:12/16/2020
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Patient Information for Dyshidrotic dermatitis in Adult
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Dyshidrotic dermatitis in Adult
A medical illustration showing key findings of Dyshidrotic dermatitis : Fingers, Palms and soles, Recurring episodes or relapses, Toes, Pruritus
Clinical image of Dyshidrotic dermatitis - imageId=330537. Click to open in gallery.  caption: 'Cloudy vesicles, tiny brown crusts, and some scale on the palmar aspect of the fingers.'
Cloudy vesicles, tiny brown crusts, and some scale on the palmar aspect of the fingers.
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