What is the cause of small clear vesicles between the fingers, possibly dyshidrotic eczema (also known as pompholyx)?

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Last updated: April 28, 2025View editorial policy

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Differential Diagnosis for Small Clear Vesicles between the Fingers

  • Single most likely diagnosis
    • Dyshidrotic eczema (also known as pompholyx or vesicular palmoplantar eczema): This condition is characterized by the appearance of small, clear vesicles on the palms and soles, often accompanied by itching and burning sensations. The vesicles can burst, leaving behind crusts and scales. It's a common condition that can be triggered by stress, allergies, or exposure to certain metals.
  • Other Likely diagnoses
    • Contact dermatitis: This is a type of skin inflammation caused by contact with irritants or allergens, which can lead to the formation of vesicles. It's likely if the patient has recently started using a new soap, detergent, or has been exposed to a potential allergen.
    • Irritant contact dermatitis: Similar to contact dermatitis, but caused by exposure to irritants rather than allergens. It can occur after prolonged exposure to water, soaps, or other substances that strip the skin of its natural oils.
    • Tinea manuum (fungal infection of the hand): Although less common, fungal infections can cause vesicular lesions between the fingers, especially in individuals who frequently wash their hands or are exposed to moist environments.
  • Do Not Miss diagnoses
    • Scabies: A parasitic infection caused by the mite Sarcoptes scabiei, which can lead to severe itching and the formation of small vesicles or burrows in the skin. It's essential to consider scabies due to its contagious nature and potential for severe discomfort.
    • Herpes simplex virus infection: Although less common in this location, herpes simplex can cause vesicular lesions on the fingers, especially if the patient has a history of oral or genital herpes.
    • Erythema multiforme: A skin condition characterized by target-like lesions, which can sometimes appear as vesicles. It's often associated with infections, medications, or other medical conditions, and can be a sign of a more severe underlying condition.
  • Rare diagnoses
    • Pemphigus vulgaris: A rare autoimmune disease that causes blistering of the skin and mucous membranes. Although it typically affects the mouth and other areas, it can occasionally present with vesicles on the hands.
    • Bullous pemphigoid: Another rare autoimmune disease that causes blistering of the skin, which can sometimes appear as clear vesicles between the fingers.
    • Epidermolysis bullosa: A group of rare genetic disorders that cause blistering of the skin, often in response to minor trauma or friction. It can present with vesicles or blisters on the hands, among other areas.

Professional Medical Disclaimer

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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