Update: October 2018
Eczema is a chronic etiologic disease with skin
manifestations prone to recurrence is the most common
the cause of disability in dermatological practice.
Depending on the location, etiology and pathogenesis, there is
several clinical forms of this affliction. Dyshydrotic eczema –
one of them. In the overall structure of skin diseases, this clinical
form is observed in 8% of patients.
Anyone can get dyshydrotic eczema, no
reliable data on the relationship of this disease to the sex are diagnosed
in men and women equally, the age group is greatest
prevalence – persons 25 – 50 years old, less often observed in
patients of another age, in particular in children. City dwellers
sick more often than rural residents in approximate ratio
Long-term observations show that the first place among the causes
eczema development is occupied by:
- contacts with surfactants
- occupational hazard factors
- further irrational use of drugs
- detergents and cosmetics
- less often the disease causes neuropsychiatric injury or prolonged
- scuffs, burns, abrasions
- solar radiation
- infectious diseases
Dyshidrotic eczema is not transmitted from person to person.
Approximately 22% of cases determine the specific cause of the disease.
fails. 50% of people with dyshidrotic eczema determine
hereditary predisposition to allergies, the presence of parents
pollinosis, asthma, atopic dermatitis
In the etiology of dyshidrotic eczema occupies an important place
violation of sweating, in particular hyperhidrosis of the palms and feet,
due to the lability of the autonomic nervous system, impaired
neuroendocrine regulation of endocrine glands.
In children, dyshidrotic hand eczema can provoke
neuro-arthritic and catarrhal exudative diathesis. With these
states there is an increased excitability of the vegetative nervous
system, in particular hyperhidrosis of the palms and feet.
Dyshidrotic eczema is common in cleaners, washers,
workers of chemical enterprises, car services, plasterer,
have those persons who by the nature of their activities have a direct
contact with aggressive agents.
Pathogenesis and symptoms of dyshidrotic eczema
With excessive local perspiration in the excretory ducts
sweat glands fluid can linger, forming:
- Sag-like rash, in the form of small bubbles with a hard tire
and clear liquid inside
- the primary elements of the rash first appear on the lateral
finger surfaces, then spread to the palmar or
plantar surface of the limbs
- while the patient is severely itchy
- then edema and hyperemia of local tissues increase
- vesicles can be opened by themselves or as a result
combing, forming small surface erosion with abundant
clear secretions, the skin of the palms and feet begin
- secondary infection often occurs, resulting in
wounds can fester, cracks appear on the skin,
hyperkeratic layering, skin pattern is enhanced
- painful joints join painful itching
The disease can occur in all stages at the same time,
therefore, on examination, one can observe the primary elements of the rash,
erosion, peeling of the skin, purulent blisters and other signs immediately.
The disease often has a chronic course with periods of exacerbations and
Poor treatment. Обострения провоцируют stressовые
situations, contact with surfactants and other chemical agents,
microtraumas, attritions of palms and feet, excessive insolation,
Elements of dyshidrotic eczema rash on fingers that
появляются в случаях сильных stressов, в жаркое время года,
исчезают самостоятельно при устранении the reasons, если исключить
probability of secondary infection.
I would like to draw the attention of readers without medical
education, do not try to diagnose yourself and
prescribe treatment, remember that most medical errors
allowed by the fault of the patients. Late appeal to
specialists for help and self-medication can significantly distort
clinical picture, which will significantly complicate the quality
Dyshidrotic eczema of the hands and feet should be distinguished.
- contact dermatitis
- dishydrotic mycosis
- plantar palmar psoriasis
- and other types of eczema
It is only possible to distinguish dyshydrotic eczema from mycosis.
using a laboratory method, examining tissue scraping under a microscope. So
these two diseases can be combined and diagnosed in
There are many ways to treat dyshidrotic eczema,
an individual approach to each patient is important for success,
impact on the main link of the pathogenetic chain (the reason
occurrence). Before treatment, detected and eliminated
pathological foci, provocative factor – scars
after skin trauma, neurosis, chronic infectious
diseases, lesions of internal organs. And also whenever possible
eliminated various external factors that are annoying
action on the patient’s skin and nervous system.
Do not use several different topical preparations.
or oral medications simultaneously, in the case of
the occurrence of intolerance will be difficult to determine exactly what
the substance provoked it. Since this category of patients
suffers from hypersensitivity to drugs, therefore
First, the ointment for dyshidrotic eczema is used on a limited
hearth, and after establishing portability on all affected
In eczema, the leading links of the pathogenetic chain are:
- CNS dysfunction
- dysfunctions of the autonomic nervous system associated with
- hormonal disorders
- dysfunction of the digestive system
- dysfunctional discharge
- immunity disorder
- violations of protein, carbohydrate, fat metabolism
For dyshydrotic eczema, treatment should be comprehensive.
The general part is aimed at correcting the disturbed functions of the body in
whole The course is prescribed depending on the stage of the inflammatory
process, the presence of pyoderma, and the appearance of the rash. Local goal
treatments reduce or negate the skin manifestations of the disease,
restore the working ability of a sick person. Apply to:
- Soothing and antihistamines
Prescribe sedatives (sedatives, hypnotics), and
also antihistamines such as Cetrin, Erius, Zyrtec,
Tavegil, Suprastin (see the list of drugs for allergies), drugs
- Local funds
When weeping eczema with symptoms of pyoderma apply lotions from
solutions, dressings change every 15 -20 minutes:
— борной кислоты 1-2% — резорцина 0,25%
— танина — фурацилина — нитрата
Details about ointments and creams for allergies, as well as non-hormonal
ointments from dermatitis and eczema read in our articles (cream and ointment
Radevit, De-panthenol, Eplan, Elidel, Gistan, Naftaderm, Losterin,
Fenistil, Timogen, Losterin, Aisida, Destin, Solcoseryl,
When attaching a secondary infection, antibacterial drugs are shown.
ointment – Fucidin, Levocin, Lincomycin ointment, Bactroban,
Erythromycin or Gentomicin ointment. Possible application
antiseptics – Chlorhexidine and Miramistin solutions before
After removing the acute manifestations of the disease, if there are cracks,
erosions, only prescribed by the physician with a short course of pulse therapy
Corticosteroid ointments are shown (see list of all
possible hormonal ointments). Not recommended for use
hormonal ointments for a long time, poorly tolerated when applied
other outdoor agents and reversed developmental delay
rashes, they can cause systemic side effects, steroid
addiction and with prolonged use lead to atrophy
Physiotherapy methods are widely used. Physical factors
have a beneficial effect on increasing resilience
organism, strengthen the protective and adaptive mechanisms, allow
reduce the number of drugs:
- along with ultrasound
- magnetic laser
- darsonvalization is effective
- herbal and aromatic baths
- recommend radon, mineral, hydrogen sulfide baths,
mud cure in courses of sanatorium-resort treatment (climate change,
rest in sanatoria in the autumn and summer period contribute
After this treatment, there is a significant improvement in the condition.
skin and general condition of the patient.
- Vitamin therapy
In order to prevent relapse, successfully used
phyto-vitamin treatment, selected for each type of eczema.
Vitamins A and E, or multivitamin complexes with A and E,
Riboflavin, nicotinic acid, retinol, ascorbic acid and
vitamins of group B, especially B12, B6 and B1 (see vitamins in tablets-
harm or benefit)
- Skin protection from external influences
When working with chemical or unfamiliar substances you need
protect your hands with rubber gloves to protect sensitive skin
it is recommended to wear cotton gloves for them.
Because the inner surface of rubber gloves is treated
powders that can irritate the skin, and the accumulation of natural
moisture causes maceration.
For personal hygiene is not recommended to use shampoos and gels.
for a shower with fragrances and dyes, is considered the ideal means
baby soap or specially designed hypoallergenic
skin care products. Soие же рекомендации по уходу за
clothes and bedding, which is an automatic wash
must be rinsed twice.
In the presence of skin manifestations on the feet, do not recommend
use socks and tights made of synthetic fabrics, besides
that they do not have sufficient ability to absorb moisture and
pass the air, they themselves can cause allergic
reaction. Shoes must be selected comfortable, “breathable”, preferably
also from natural materials. Shoes need careful
care, washing and drying in order to avoid fungal and bacterial
Preventive measures include the normalization of the regime
of the day, keeping to a diet with the exception of foods that cause allergies,
as well as salt, spicy salted semi-finished products (sausage
products, cheese, smoked foods), fast-absorbing carbohydrates (honey,
rich products, sugar, confectionery), alcohol.
- Psychologist help
Dyshidrotic eczema, besides physical suffering, causes
quite tangible moral suffering to the patient, due to the unsightly
the appearance of open skin and excessive attention
surrounding people. In case the patient is difficult on his own
To solve this problem, he is recommended treatment by a psychologist.
- Folk remedies dyshidrotic
From the means of traditional medicine for external use
sea buckthorn oil is recommended, it soothes the skin perfectly,
has a pronounced wound-healing effect, leaves no scar
changes. In the absence of individual sensitivity,
The affected skin should be oiled twice a day.
Для дисгидротической eczema рекомендуют отвары и настои для
rinsing from the flowers of elderberry, yarrow, peppermint,
sage, oak bark, succession.
Автор: Мельникова Светлана Георгиевна врач-дерматолог