Name
DYSHIDROSIS
DESCRIPTION
DETAIL
CAUSES : β’ Exact cause is not known β’ May represent an id reaction especially to a dermatophyte infection, atopic reaction, reaction to allergens β’ Stress may play a role since dyshidrosis is more frequent in anxious individuals, and those with psychosocial stress β’ Hyperhidrosis is not a cause, but is often associated with the disease -------------------------------------------------------------------------- DIFFERENTIAL DIAGNOSIS β’ Tinea manuum or pedis β’ Id reaction β’ Contact dermatitis β’ Atopic dermatitis β’ Drug reaction β’ Dermatophytid β’ Pustular psoriasis β’ Seborrheic dermatitis β’ Acrodermatitis continua β’ Pustular bacteridDIAGNOSTIC PROCEDURES β’ Diagnosis is usually based on clinical exam β’ Skin biopsy
TYPENOTES
RISK FACTORS : β’ Atopic dermatitis β’ Contact dermatitis β’ Dermatophytosis β’ Bacterial infections β’ Foods β’ Drugs, such as aspirin or other salicylatesGENERAL MEASURES : . Avoidance of possible causative factors (see Risk Factors) . Though hyperhidrosis is not a cause, excessive sweating may increase pruritus and burning . Moisturizers will give symptomatic relief of dry scaly lesions . If feet involved: . Wear shoes with leather soles rather than rubber (e.g., sneakers) . Wear socks made of cotton instead of synthetic materials . Remove shoes and socks whenever possible to allow sweat evaporation and to apply lubricants DRUG(S) OF CHOICE : . Dyshidrotic eczema-mild cases . Topical steroids (medium to high potency), or . 5% salicylate in alcohol (provided salicylates are not a cause), or aluminum acetate (BurowΒfs solution) compresses . Moisturizers for symptomatic relief . Dyshidrotic eczema-moderate to severe cases . A systemic corticosteroid such as short course of oral prednisone . Intramuscular ACTH or triamcinolone acetonide 40 mg . PUVA (psoralens and ultraviolet A) therapy is effective therapy (including mild cases) . Tap water iontophoresis and low dose methotrexate have also been shown to be helpful in recalcitrant cases . UV-B has also shown benefit . Lamellar dyshidrosis . Application of coal tar (Estar) preparations . Intramuscular corticosteroids . Keratolytics and moisturizers are sometimes helpful PATIENT MONITORING : As needed PREVENTION/AVOIDANCE : β’ Control of emotional stress, avoid sweating β’ Treatment for psychological factors, if appropriate POSSIBLE COMPLICATIONS : Bacterial secondary infections EXPECTED COURSE/PROGNOSIS : β’ Benign and without scarring β’ Lesions will often resolve spontaneously, though faster with appropriate treatment β’ Recurrence is the rule rather than the exception
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
COMPLETE BLOOD COUNT, BIOPSY