Dyshidrosis

The Dyshidrosis ( syn. dyshidrosis, dyshidrotic eczema, dyshidrotic eczema or pompholyx ) is a disease of the skin. It manifests itself in the form of small, almost always itchy blisters on the fingers side faces, palms and soles ( Podopompholyx ). The name has historical reasons. Contrary to earlier assumptions, however, there is no relationship between these lesions and the function of the sweat glands (Greek δυσ, dys = "miss, bad, bad "; Greek ἱδρώς ( HIDROS ) = " sweat" ).

Cause and pathogenesis

A clear cause for the emergence of dyshidrotic eczema could not yet be identified. The Dyshidrosis occurs very frequently in atopic patients and in conjunction with contact allergies or intolerances of drugs as well as fungal infections. In addition, chronic skin damage by alkaline soaps or detergents favor the occurrence of a dyshidrosiformen eczema, for example. Furthermore, exposure of the skin with heavy metal salts ( eg, chromium, nickel and cobalt salts) can be a trigger. As a cofactor stress situations are discussed.

Clinical manifestations

The symptoms mainly occur on the palms, fingers side palms and soles. There are small, water-clear and usually intensely itchy blisters on the affected areas of skin. In a histological examination of the tissue is spongy ( spongiotic ) show vesicles within the epidermis (the epidermis). The affected skin is usually reddened. The lesions may occur intermittently or drag on for a long time. The bubbles can burst and then begin to saturate, which may lead to infections. In the healing of the skin peels. With longer duration of disease keratinize the affected skin and make it yourself bleeding crack sites ( fissures ).

Variants

Dyshidrosis Sicca

With only minor changes in the skin which blisters dry without signs of inflammation rapidly again. This results in characteristic circular and dry cavities in the horny layer, which then flake -like frill. This variation often occurs in the presence of atopy.

Cheiropompholyx and Podopompholyx

At the wrists ( Cheiropompholyx ) or soles ( Podopompholyx ) occur up to cherry- sized bubbles that merge with each other. As a complication of bacterial and fungal secondary infections can occur.

Treatment

Treatment should be based on the cause of the lesion. Therefore, treatment of the underlying disease may be necessary. A short-term topical treatment with glucocorticoids as a lotion or cream for a few days is usually the most effective. May optionally be used to cover additional zinc - shake mixture. For the dehydration of the vesicles can be useful (eg as a bath additive ) externally Gerbstoffpräparate. A more recent approach to the treatment is the oral administration of the vitamin A derivative alitretinoin ( 9-cis- retinoic acid). Such drugs can in particular for patients who do not respond to treatment with potent topical corticosteroids, an alternative. To be avoided are frequent (z. B. profession conditional ) washing or disinfecting the hands. Also contraindicated is the use of gloves ( for example tight-fitting work gloves, latex or non- latex, rubber, PVC gloves ). Relapse episodes can lead to disability.