Dyshidrotic Eczema Treatment and Causes

Dyshidrotic Eczema - Dyshidrotic Eczema refers to a pattern of peculiar inflammatory skin reaction of the hands and feet that involves multiple triggers, both internal and external factors. Despite its name, not shown any relationship with the sweat gland or sweating, being unknown etiology of the same. Predisposing factors include atopy, contact with irritants, some contact allergens, drugs administered orally and the existence of stress.

Dyshidrotic Eczema

Clinically affects young adults, presenting eczematous lesions localized form symmetrical and bilateral, on the side of fingers of hands and feet and span surfaces - Plantar. In 80% of cases it is located on the palms and the remaining 20% of the patients in the palms and plants or just plants. The predominant lesion is the gallbladder, which is transparent, tight, firm and persistent whose appearance resembles "sago grains". Sometimes squito lesions come together resulting in blisters and other times you can see associated Pustular lesions, but with a predominance of vesicles. The number of injuries can be very variable, since few lesions grouped in plates located on the lateral and ventral sides of fingers, until more extensive lesions diffusely affecting the hands and feet. It is often accompanied by intense itching, which, in the majority of cases, precedes the appearance of the skin lesions. The outbreak usually has a limited, with a duration between 2 to 3 weeks, dewatering lesions and forming small scaly collaretes, which disappear without leaving residual lesions. Sometimes only observed injuries in nail-shaped depressions blade nail or side pit to the involvement of the nail matrix by the inflammatory process. Recurrences are frequent outbreaks of highly variable, and may have an subintrante evolution intensity, duration, and periodicity. In some patients the outbreaks occur annually each summer.

Dyshidrotic Eczema Treatment and Causes

The biopsy of the lesions show a gallbladder intraepidermica spongy, with a little intense inflammatory infiltrate. It may be useful to rule out other inflammatory processes that involve a similar clinic as Pemphigoid dishidrosiforme, IgA lineal and, in pregnant women disease, herpes gestationis.

In some cases it would be indicated performing testing allergic patch, especially if we suspect the possibility of a sensitising of contact involved in the emergence and persistence of the lesions.

The differential diagnosis of the eczema, Dyshidrotic of hands and feet is established with pustulosis span - plant, fungal infection and allergic contact eczema. In cases of pustulosis span - plantar psoriasis outside the region span plates - you can see planting and a predominance of Pustular lesions in the active phase. A fungal infection should be suspected before a clinical pattern of asymmetrical Dyshidrotic Eczema and short evolution, especially when the lesions adopt a ring pattern or is observed active edge. It is confirmed with the direct microscopic examination of the scales with KOH or through mushroom cultivation. In the Allergic Contact Eczema lesions may be asymmetric and tend to have greater involvement of the dorsum of the fingers and hands, except when contact is almost exclusive to the Palm of your hands. The diagnosis is confirmed with the patch testing. Often the patient observes a direct chronological relationship between contact with the so-called allergen and the location of the skin lesions.

The treatment of choice for Dyshidrotic Eczema are the topical corticosteroids of medium or high power given the location of the lesions, in a daily application for 2 to 4 weeks, followed by a descending pattern. During the first days, in the exudative phase, the promotions drying before applying creams can be indicated. In the event that the outbreak is very intense or disabling treatment with corticosteroids may be indicated systemic such as prednisone, at doses of 0, 5 - 1 mg/kg/day for a few weeks, in guideline down to achieve improvement. Topical therapy for hands and feet, which can be very effective can be evaluated in cases of chronic evolution.

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