Dyshidrosis Also Known As Dyshidrotic Eczema

Hi, not sure if there is a thread for this, but I have been cursed with this on my hands for almost 3 years now, and it really sucks to have it. It started my senior year of high school, I had never had any problems with my skin before, and now I have allergies and sensitive skin too because of this.

There is no cure for it yet, and I take prescription medication (ointment) for it, but I want to know if there are ways people use to prevent it from happening. I was misdiagnosed as something else, but then I got a second opinion and it turned out to be this.

The doctor said it is due to stress and anxiety in some cases, and that they can only prevent it, but cannot cure it or make it go away.

For me when I have an outbreak it is always in the same areas, and once that start happening for me you can tell what area it happened in when it isn't there. Since the skin looks different there. For me it starts as small bumbs, that gradually get bigger, and sometimes can be painful. It makes it easier to get a skin infection, which has happened to me twice. That is when it is really painful. I hate that it happens on my hands, since I will not shake hands with people most of the time, even though it is NOT CONTAGIOUS, I feel insecure about it. It seems to me like it never completely heals when it calms down, in between outbreaks, there is a difference still in those areas of my hand.

Hopefully this information will be helpful to some!!

Here is some info from Wiki about it:

Dyshidrosis, also termed Dyshidrotic Eczema, Pompholyx and Dyshidrotic Dermatitis, is a skin condition that is characterized by small blisters on the hands or feet. It is an acute, chronic, or recurrent dermatosis of the fingers, palms, and soles, characterized by a sudden onset of many deep-seated pruritic, clear vesicles; later, scaling, fissures and lichenification occur. Recurrence is common and for many can be chronic. Incidence/Prevalence is said to be 20/100,000 in the USA, however, many cases of eczema are diagnosed as garden-variety atopic eczema without further investigation, so it is possible this figure is misleading.

This condition is not contagious to others, but due to its unsightly nature can cause significant distress in regards to social interactions with others.

The name comes from the word "dyshidrotic," meaning "bad sweating," which was once believed to be the cause. Sometimes called pompholyx (Greek for "bubble") which is generally reserved for the cases with blisters; in some countries, pompholyx refers to hand dyshidrosis

Symptoms

Small blisters with the following characteristics:

* Blisters are very small (1 mm or less in diameter). They appear on the tips and sides of the fingers, toes, palms, and soles.

* 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.

* Blisters may itch, cause pain, or produce no symptoms at all. They worsen after contact with soap, water, or irritating substances.

* 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. The skin is dry and scaly during this period.

* Fluid from the blisters is serum that accumulates between the irritated skin cells. It is not sweat as was previously thought.

* In some cases, as the blistering takes place in the palms or finger. Lymph node swelling may accompany the outbreak. This is characterised by tingling feeling in the forearm and bumps present in the arm pits.

Causes

* Causes of dyshidrosis are unknown, however, a number of triggers to the condition exist.

* Dyshidrosis has been historically linked to excessive sweating during periods of anxiety, stress, and frustration, however, many cases present that have no history of excessive sweating, and the hypothesis of dyshidrosis as a sweating disorder is largely rejected. Some patients reject this link to stress, though as a trigger of vesicular eruption it cannot be overlooked, as with other types of eczema.

* Vesicular eruption of the hands may also be caused by a local infection, with fungal infections being the most common. Sunlight is thought to bring on attacks, some patients link outbreaks to prolonged exposure to strong sunlight from late spring through to early autumn.[citation needed]. Others have also noted outbreaks occurring in conjunction with exposure to chlorinated pool water or highly treated city tap waters.

* Soaps, detergents, fragrances and contact with fruit juices or fresh meat also can trigger outbreaks of dyshidrosis, as with other types of eczema.

* Systemic nickel allergies may be related.

* Keeping skin damp will trigger or worsen an outbreak. For this reason, people with dyshidrosis should wear gloves, socks, and shoes made of materials which "breathe well", such as cotton or silk. Certain fabrics may greatly irritate the condition, including wool, nylon and many synthetic fabrics.[citation needed]

* Inherited, not contagious. Often, patients will present with other types of dermatitis, such as seborrheic dermatitis or atopic eczema. For this reason, among others, dyshidrosis is often dismissed as atopic eczema or contact dermatitis.

* Can be the secondary effect of problems in the gut.[citation needed] Some sufferers claim diet can ease symptoms (relieving internal condition of IBS or intestinal yeast infection).[citation needed] Also Inflammatory bowel diseases of Ulcerative colitis and Crohn's disease.[citation needed]

* Bandages, plasters or skin-tapes may be irritating to dyshidrosis and should be avoided. As the skin needs to breathe, anything that encourages maceration of the palms should be avoided. If the 'wounds' are raw enough to warrant covering, pure cotton gloves or gauze should be used.

* Latex and vinyl gloves may increase irritation.

* Multiple Chemical Sensitivity

Treatment

There are many treatments available for dyshidrosis, however, few of them have been developed or tested specifically on the condition.

* Topical steroids [1] - while useful, can be dangerous long-term due to the skin-thinning side-effects, which are particularly troublesome in the context of hand dyshidrosis, due to the amount of toxins and bacteria the hands typically come in contact with.

* Nutritional deficiencies may be related, so addressing diet and vitamin intake is helpful

* Hydrogen Peroxide - posited as a cure-all on a popular website, it is used in dilutions between 3% and 35% strength, but side-effects of its use include burning and itching, and there is argument as to whether it only attacks the 'sick cells'.

* Potassium permanganate dilute solution soaks - also popular, and used to 'dry out' the vesicles, but can also be very painful and cause significant burning.

* Emollients during the drying/scaling phase of the condition, to prevent cracking and itching. While petroleum jelly may work well as a barrier cream, it does not absorb into the skin and or allow it to breathe, so may actually be less helpful.

* Salt soaks

* White vinegar soaks

* Avoidance of known triggers - dyshidrosis sufferers may need to abstain from washing their own hair or bodies, or wearing gloves when they do so, however waterproof gloves are often potential irritants.

* Zinc oxide ointment

* Nickel-free diets

* When in the scaling phase of the condition, the scales may cause deep cracks and fissures in the skin. Filing (as with an emery board) may help to minimise this.

* Stress management counseling

* Light treatment: UVA-1, PUVA, Grenz Rays

* Ciclosporin a strong immunosuppressant drug used to combat dyshidrosis caused by ulcerative colitis

* Efalizumab (Raptiva) a medication used to treat psoriasis

* Tacrolimus and Pimecrolimus, potent immunomodulators often used to prevent organ rejection in topical, ointment form, may be used in severe cases.

* Unbleached cotton gloves may be used to cover the hands to prevent scratching and vulnerability of the skin to bacteria

Many sufferers of dyshidrosis will find that treatments that were previously suitable for them no longer work or have induced sensitive reactions, which is common in most types of eczema

Allergy testing

Allergy testing is a contested subject among eczema communities. Some dermatologists posit that if a sufferer is allergic to a substance, then a general allergy test on the forearm will suffice, yet others believe that in conditions like dyshidrosis, the suspect substances need to be applied to the affected area to induce a reaction.

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So if you also have this maybe you have tips/advice/experience you want to share, that can help me and others. If so please do, it would be most appreciated!!

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Here is more info from Mayoclinic.com, to help all of us out there....

Introduction

Dyshidrosis, also known as dyshidrotic eczema or pompholyx, is a skin condition in which small, fluid-filled blisters (vesicles) occur on the palms of your hands or the soles of your feet, or both.

The blisters that occur in dyshidrosis last up to three or four weeks, and cause intense itching. Once the blisters dry, cracks and grooves (fissures) form, which can be painful.

The cause of dyshidrosis isn't known. Treatment for dyshidrosis most often includes topical creams, wet compresses and ultraviolet light therapy. Even with treatment, recurrence of dyshidrosis is common.

Signs and symptoms

Dyshidrosis is marked by small, itchy bumps that gradually progress to a rash made up of fluid-filled blisters (vesicles). Other signs and symptoms may include:

* Intense itching

* Cracks or grooves (fissures) on your fingers or toes

* Pain, especially with large blisters

Causes

Dyshidrosis

The cause of dyshidrosis is unknown. However, it can be associated with a similar skin disorder called atopic dermatitis and other allergic conditions, such as asthma and hay fever (allergic rhinitis). Eruptions may be seasonal in people with allergies.

In dyshidrosis, the affected skin becomes inflamed (dermatitis). As a result, the junctions between the skin cells open and allow fluid (serum) to fill the spaces. Doctors refer to this process as spongiosis because the skin becomes more sponge-like with these many fluid-filled spaces.

The resulting small, fluid-filled blisters (vesicles) most commonly occur on the palms and fingers of your hands and on the soles and toes of your feet. The blisters usually last for three to four weeks.

The blisters often cause intense itching. Scratching the blisters can damage the skin and, in some cases, lead to infection. Once the blisters dry, they often leave cracks and painful grooves (fissures) in your skin.

Risk factors

Dyshidrosis occurs twice as often in women as in men. Other risk factors include:

* Stress, because dyshidrosis appears to be more common during times of stress

* Exposure to metal salts, such as chromium, cobalt and nickel — usually through cement or mechanical work

* Having seasonal allergies, such as hay fever (I have this

* Frequently exposing your skin to water or other wet substances

When to seek medical advice

Call your doctor if you have a rash on your hands or feet that doesn't go away on its own after a few days.

Also contact your doctor if you've been diagnosed with dyshidrosis and have signs and symptoms of an infection, including fever, or pain or inflammation at the rash site.

Screening and diagnosis

In most cases, your doctor can diagnose dyshidrosis based on a physical exam.

Occasionally, a skin biopsy is necessary to confirm the diagnosis or to rule out another cause. In this test, your doctor removes a small sample of the affected skin. The skin sample is examined under a microscope to confirm a diagnosis of dyshidrosis.

Your doctor may also recommend a procedure called a KOH test to rule out other causes, such as a fungal infection. To perform a KOH test, your doctor scrapes your skin with a glass slide to collect dead skin cells. The skin cells are mixed with potassium hydroxide (KOH) and viewed under a microscope to help single out a fungal infection.

In cases where an allergy is suspected to cause dyshidrosis, a patch test (contact hypersensitivity allergy test) may help determine a possible cause. During a patch test, potential allergens are applied to a patch, which is then placed on your skin to check for a reaction.

Complications

For most people, dyshidrosis is just an itchy inconvenience. For some, however, the pain and itching may limit the use of their hands. Recurrence, which is common, can be frustrating.

In some cases, skin damage (including thickening of your skin), or a bacterial infection may occur as a result of the open, sponge-like skin or due to intense scratching. This can make treatment lengthier and more difficult.

Treatment

A treatment plan for dyshidrosis may include:

* Corticosteroid creams or ointments. (I use this) Your doctor may prescribe high-potency corticosteroid topical creams, such as clobetasol propionate (Temovate, others), to help speed the disappearance and improve the appearance of the blisters, and to treat the cracks and fissures that occur after the blisters have dried.

* Compresses. Wet or cold compresses can help alleviate itching, increase the effectiveness of the topical creams and minimize blisters.

* Antihistamines. Your doctor may prescribe anti-itching medications called anti-pruritics or antihistamines, such as diphenhydramine (Benadryl) or loratadine (Claritin), to help alleviate itching.

If these treatments aren't effective, your doctor may recommend a special kind of ultraviolet light therapy called psoralen plus ultraviolet A (PUVA). This treatment combines exposure to ultraviolet light (phototherapy) with drugs that help make your skin more receptive to the effects of ultraviolet light (psoralens).

Some doctors may consider recommending botulinum toxin injections to treat severe cases of dyshidrosis. This is a relatively new treatment option that has not yet gained acceptance among all physicians.

Recurrence of dyshidrosis is common even after treatment. (That is what sucks the most)

Prevention

Because the cause of dyshidrosis is generally unknown, there's no proven way to prevent this condition.

However, managing stress and avoiding exposure to metal salts, such as chromium and nickel, may help prevent dyshidrosis.

Self-care

If you have dyshidrosis, the following self-care measures may help:

* Avoid scratching the rash

* Limit your skin exposure to water

* Moisturize with a hand cream after washing your hands

* Take measures to protect your hands from irritants, such as perfumed lotions or dishwashing soap

is this that thing where your hands have so many tiny lines on them?

sorry, i didn't read the whole thing and it had too many big words. lol

whoa, long post. didn't read all of it. ^^; Dyshidrotic Eczema...? never heard of it, but my sister and cousin have normal eczema? i didn't know there was more than one type of eczema.

from what i know, eczema goes away as you get older. at least, the kind that my cousin and sister have because they had it when they were young. you can't cure it, so you can only treat it until that time comes. you can't really "prevent" it from happening...i think the wiki site covered all that you really can do now.

i had that same problem but it wasnt as bad as yours it was when i was in like.. 8th grade i think. i had all these bumps on my hands and i was freakin out so i went to the dermatologist. all they diagnosed it as was hand eczema. so i guess it wasnt severe. they gave me a bunch of different ointments to put on my hand every few hours or everyday. i felt like a weirdo going to schoool with shiny hands

i hope somehow you cure yours.. even though you said it can't be cured. maybe itll go away? o_O doctors can be wrong :P

is this that thing where your hands have so many tiny lines on them?

sorry, i didn't read the whole thing and it had too many big words. lol

no, it occurs on your feet or hands, for me it is on my hands, and it starts of as tiny bumbs, like a rash and they get bigger, and become small-large blisters, the bigger the more painful it may be.

For example:

Example 1

i have it on my pink some times.. well usually during exam time when i'm stressed out.. ahha i used to poke the bumps open with a needle.. ==" foolish me.. my mum gave me this chinese ointment ( it's anti bacterial too) and it worked.. so YEAH FOR ME but i still get it during high stress times.. =(

I have this and my case of eczema's really severe.

I constantly scratch my pinky, ring and middle finger because it itches so much. Sometimes it stings like crazy and it hurts to wash up because of the contact with water.

I have rashes in the middle of my arm too (opposite of the elbow) as well as redness on my face. Some days are better than others and those are the days when people don't notice it but it still sucks.

I've been to many doctors and received prescripted steroids that only worked temporarily. I've actually learned to live with it and my mom's recently gotten me some dietary supplements (since she thinks I'm lacking vitamins). Anyway, good luck!

Yea I have it too, on my fingers and wrist area. Dont scratch or pop it!! god that is the worse thing to do. Just let it dry as dry as possible, soap usually makes it worse for me. I try and not soak my hands in water for a long time or else more of them pop up. Most ointments I use don't really work...so yea I tried a lot before.

You have to let it dry so that new skin can grow on top of it and replace the dry cracked skin and usually the outbreak won't come back as easily as when your skin is very thin like. Like I would shower using one hand to do all the work with scrubbing so that I can keep that other hand dry out of water =/

I believe my outbreaks are due to weather and the quality of tap water, because depending on where I am, but body reacts differently.

Good luck with it, and don't touch it! keep that as dry as possible.

I have eczema and most of the time it's REALLY bad. I had it on my hands when I was in sixth grade really bad for about three months. It was red and blistering and just completely awful. I had scarring for a year or so, but it went away. People don't believe that I had it that bad except for those who remember, I'll see if I can dig up a picture.

I used to get the little blisters on the side of my index finger, and it would get really red and irratated. All I can say is shorten the time on your showers/baths, cold showers (not freezing, but warm water isn't good for people with eczema), lotion really helps. I use the lubriderm, the one for normal dry skin, after ever shower now. It does help.

I have eczema and scarring on the back of my legs, I'm not too good at listening to my dermotologist all the time. Some medicines I use are Triamicinolone (ointment) for when it still red and irratated, and Betamethasone Dipropionate (cream) when it's not so red. Use it in very thin layers because it does contain steroids and may discolor skin.

I hope that helped!

i also found out i have this too

except mine isn't worse.

its just sometimes one-three bubbles together or on different fingers

i usually pop em, and its fun but my mom told me not to worry about it

would it be okay if i didn't really check it out? or would it keep getting worse?

ooh I have a terrible eczema condition. It used to be on my arms when I was younger, but

it started on my face this year T_T

My type of eczema is probably different from yours, cuz the dermatologist said I have

eczema because my skin is extremely dry, so now I just put like tons and

tons of lotion on at night. I had an infection once also, but now I have it a little under control

although I can only use my medicine every two weeks or I'll become immune to it

but yeah...no cure :tears:

Oh yea there is no permanent cure. :/ only stuff to make it better.

Because it could stop and come back after years.

:U I've had that since I was six. Most of the time I thought I got it was because I was born in a tropical place and then suddenly moved to the East coast in winter time. >>;

I used to bleed a lot in class and get made fun of by these nerds. But they go away with some ointments I got from China~ x)

i also found out i have this too

except mine isn't worse.

its just sometimes one-three bubbles together or on different fingers

i usually pop em, and its fun but my mom told me not to worry about it

would it be okay if i didn't really check it out? or would it keep getting worse?

popping it will most likely make it worse, also itching it too.

I hear aloe vera helps. It's usually beneficial for most poor skin conditions. Try it out~

Ah, well. Never knew so many people had eczema too. I've had eczema since I was 7, I think. It's so far back I don't remember when it started. My eczema jumps around a lot, so it sucks. The only thing you can really do is put the right kind of medicine on the affected area. Besides keeping your hands clean and dry, yet moisturized, heh.

Hydrocortisone: It stops itching, and the cream is probably more pleasant than the ointment when it comes to hands. The cream is slippery whereas the ointment is like petroleum jelly.

Triamcinolone: I've only seen this as an ointment. It's not something you want to use excessively, since it can thin out your skin. It's good to use when you have broken, thicker, healing skin over new skin. Whenever I have dry, chapped skin or scabs, I use this. It makes a significant difference. Amazing stuff, if you use it correctly. But be careful, I've heard that sometimes the little blood vessels in your skin might be a little visible if you use it excessively.

Ellidel: This is a new one to me. But, it has roughly the same effects as Triamcinolone. I think it's not as strong, since it doesn't thin out your skin. This is pretty good for the very beginning of your symptoms, after you've dealt with a breakout and you don't want another one to come up.

At some points, here and there, I am able to stop using all of the aforementioned medicines. But it takes a lot of self-control, discipline, and resistance to avoid picking at breakouts a lot. A couple of days ago I felt like I needed to scratch at my face. But I looked at the mirror and there was nothing on my face. People won't really see the symptoms you get until you've gone too far and scratched. So just think about the fact that no one else will really see your symptoms until you make them worse.

And, while you have eczema, use it as a learning experience when it comes to confidence. Honestly. I know it sounds cheesy, but having eczema makes my self-worth very strong when it comes to superficial beauty like that. I have so many scars and it took years to realize that I'm not ugly/bad for having them. Then again, I don't know if other people felt ugly/like a crappy person like I did. Who knows?

Take care of yourseeeeelf. (:

^^^^^^^^^ thanks for all the info, I use the first one as an ointment, but I am thinking of switching to the cream, the ointment is so shiny and noticeable, so I only use it before I go to bed. It has taught me a lot about beauty not being only skin deep, but it is a bit sad when people stare at it, and start asking a lot of sometimes rude questions about it.

I have it too, keep yourself moisturized ALL the time. If your skin is dry, put on that lotion and don't ever get lazy! Take lukewarm short baths. By soaking your skin in warm water, the water can moisturize your skin, then immediately put on lotion (and steroid cream if necessary) to lock in that moisture. Exposure to sunlight can also help heal your skin, but not too much of course or that'll just dry out your skin.

With eczema, instead of the itch appearing after the rash, the itch appears before the rash. That's why sometimes you won't even see a problem on your skin, although it's feeling itchy like crazy. So if you don't scratch it, most likely you won't see much redness.

Hydrocortisone is also pretty weak, you can buy them over the counter in drug stores. It might be that you need something a little bit stronger, which your dermatologist can recommend you.

I also find vaseline to be a great moisturizer, it's really cheap, it doesn't sting at all if you put it over your cuts or anything.

Also, stress and sweat are two main things to avoid when it comes to eczema. Good luck!

Oh and there's a thread you can see here about it too: http://www.soompi.com/forums/index.php?showtopic=59445

^^^thanks, didn't know there was a thread, but since this one is more specific, I guess it is still valid. Moisturizing is key, so always carry lotion, a cream is thicker and more moisturizing though. Also I notice that I'll have a breakout cause the area will feel different, tingly, and of course itchy. So once that happens I start treating it too make it less of a breakout.

weird. When I put moisturisers, lotions etc etc. It seems to only make it worse, I get this stinging sensation and I know things are going to go wrong. =( Maybe you guys are lucky.