What is the presentation of dyshidrosis (eczema) of the palms?

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From the Research

Dyshidrotic eczema of the palms typically presents as small, intensely itchy, fluid-filled blisters (vesicles) on the palms, sides of fingers, and sometimes soles of feet, with a characteristic "tapioca pudding" appearance, as described in the most recent study 1. The condition often begins with a burning or prickling sensation before the vesicles appear. As the condition progresses, the vesicles may merge to form larger bullae, eventually drying and causing painful fissures and scaling. The skin becomes red, cracked, and thickened with repeated episodes. Patients frequently report intense itching that worsens at night and may experience pain when the blisters rupture or when fissures develop. Some key features of dyshidrosis include:

  • Small, intensely itchy vesicles on the palms and sides of fingers
  • Characteristic "tapioca pudding" appearance of the vesicles
  • Burning or prickling sensation before the vesicles appear
  • Painful fissures and scaling as the condition progresses
  • Intense itching that worsens at night Dyshidrosis tends to follow a chronic, relapsing course with flares often triggered by stress, contact with irritants, fungal infections, or exposure to allergens, as noted in 2. The condition is more common in young adults and those with a personal or family history of atopic conditions like asthma or hay fever. Diagnosis is typically clinical, based on the characteristic appearance and distribution of the vesicles, though patch testing may be performed to identify potential contact allergens, as discussed in 3 and 4.

References

Research

[Dyshidrosis].

La Revue du praticien, 1998

Research

Dyshidrosis: epidemiology, clinical characteristics, and therapy.

Dermatitis : contact, atopic, occupational, drug, 2006

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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