Dyshidrosis is a dermatosis characterized by vesicles of the lateral faces of the fingers and toes, as well as on the palms and the plants. It is frequent, especially in summer.
Definition of dyshidrosis
Dyshidrosis is a form of eczema called vesicular dermatosis of the hands. Dyshidrosis is distinguished from other forms of vesiculobullous eczema of the hands such as:
- the pompholyx , corresponding to a vesicular rash and / or bullous sudden palmar-plantar without redness is usually followed by a flaking of about 2 to 3 weeks and may recur
- the chronic Vesiculobullous eczema often progressing to cracking and thickening of the skin
- the hyperkeratotic dermatitis of the hands, usually affecting men between 40 and 60 is formed of thick plates that itch sometimes with cracks palms Center. It is generally of multiple cause, associating allergies of contact, irritation and chronic traumatisms (DIY …)
- Intense vesicular lesions secondary to fungal infection of the feet or hands.
Causes of dyshidrosis
The causes of dyshidrosis are poorly known, but we know that it is associated with other conditions:
- the fungal dermatophyte such the athlete’s foot
- the hyperhidrosis Palmoplantar or increased sweating of the hands and feet. In the same way it is traditional to see dishidrose appear in summer when the heat increases.
- the atopy : include a personal or family history of atopy in some studies but not in others …
- the allergy to metals (nickel, chromium, cobalt …), certain plastics (paraphenylene diamine) and Baume of Peru is found in some patients
- the tobacco could be an aggravating factor
Diagnosis of dyshidrosis
There are two forms of dyshidrosis:
- simple dyshidrosis, not accompanied by redness. We only notice vesicles on the skin
- dyshidrotic eczema, associating the vesicles and a redness or even desquamations.
In both cases the itching is often intense and it can precede or accompany the eruption of the vesicles.
The latter are clear (like “water blisters”), often roughly symmetrical on each hand and foot, they tend to converge, then:
- either they dry, often forming brown scabs.
- either they break out, forming oozing wounds
Prevalence of dyshidrosis
Dyshidrosis exists all over the world but it seems rarer in Asia. It is more common in adults than in children. It concerns both men and women.
It seems that repeated contact with irritants (household products …) and water, but also the prolonged wearing of gloves, are contributing factors of dyshidrosis. Thus the professions at risk of worsening dyshidrosis are bakers, butchers, cooks and catering trades, but also health professions and more generally all professions with hands in the water or a hot and humid atmosphere .
Evolution and possible complications of dyshidrosis
The evolution is often recurrent, sometimes punctuated by the seasons (recurrence in the spring or summer for example). Sometimes, the vesicles of dyshidrosis become infected: their contents become whiter (purulent) and they can cause a lymphangitis, a ganglion in the armpit or the groin …
SYMPTOMS of dyshidrosis
Dyshidrosis is defined by the appearance of itchy vesicles on the hands and feet. Either they are not accompanied by redness, it is simple dyshidrosis.
Or there is a redness or even desquamations, we then speak of eczema dishidrosic:
- On the feet: the rednesses sit most often on the toes, in the hollow of the foot and on the lateral faces of the feet
- On the hands: they are more frequent on the fingers and on the palmar face
Risk factors for dyshidrosis
The risk factors for dyshidrosis are:
- The fungus of the feet and hands to dermatophytes, such as athlete’s foot
- the hyperhidrosis Palmoplantar or increased sweating of the hands and feet.
- the allergies to metals (nickel, chromium, cobalt …), certain plastics (paraphenylene diamine) and Baume Peru
- the tobacco which could be a factor aggravating the repeated contact with irritants (household products …), water or a hot and humid atmosphere and extended wear gloves
|The opinion of our doctor
Dyshidrosis is a problem of skin benign but very often evoked in consultation because of the ferocious itching it provokes. Patients come to dread recurrence and often have a tube of cream ready to use …
However, chronic use of dermocorticoids, sources of long-term complications (including skin atrophy) and dependence, must be feared. The doctor must therefore ask his patients to limit the contributing factors and use the dermocorticoides only in case of crisis, only a few days and then stop them.
Prevention of dyshidrosis
It is difficult to prevent dyshidrosis because the outbreaks sometimes occur while respecting the eviction of the contributing factors:
- limitation of perspiration ,
- contact with detergent products (household products …),
- prolonged contact with water and frequent hand washing …
Among the measures to be taken to limit the risk of outbreaks are:
- Avoid contact with irritating substances and water.
- Avoid contact with products to which you are allergic if the doctor has shown a contact allergy
- Stop smoking which can be a contributing factor.
- To fight against perspiration in case of hyperhidrosis
Treatments for dyshidrosis
The local treatment is based on powerful dermocorticoids (because the skin of the hands and feet is thick), such as Dermoval , applied most often in creams, in the evening with a gradual decrease in the number of applications
UV therapy (UVA or UVB) applied locally on the hands and feet in a medical setting can reduce dishidosis and the number of relapses
Heliotherapy, a complementary approach to dyshidrosis
The heliotherapy is to expose very moderately (5 minutes per day) the hands and the feet affected to the declining sun, towards 17h the summer. It is close in terms of the mechanism of UV therapy delivered to the doctor’s office.