Dyshidrosis is also known as pompholyx and dyshidrotic eczema. Its name is a misnomer; in the 19th century it was thought to be due to a pathology of sweat glands, but it is now known that this is not the case.

It is characterised by intensely pruritic vesicles on the palms of the hands and lateral aspects of the fingers or, less commonly, soles of the feet. Vesicles are commonly 1-2 mm in size, which can coalesce into bullae.

The cause is unknown, but triggers are thought to include allergens, frequent hand washing, metals or stress. Frequent relapsing is common.

Diagnosis is clinical based on:

  • Vesicles or bullae to the palms, fingers or soles
  • Intense pruritis
  • Acute onset
  • Recurrence

Treatment includes:

  • Avoiding triggers – using soap-free cleaners and drying hands carefully after getting wet
  • Emollients
  • Barrier cream
  • Topical corticosteroid
  • Antihistamine

If it is unresponsive to these measures, difficult to treat dyshidrosis should be managed by a dermatologist.