Dyshidrotic eczema is a form of dermatitis which is characterized by formation of itchy, vesicular eruptions on the palms of the hand and soles of the feet. This condition affects adults and teenagers and can be either acute or chronic in nature. Reports have suggested that almost 50% of all patients with Dyshidrotic eczema have symptoms of atophic dermatitis.
Conventionally, this condition was believed to be associated with dysfunction of the sweat glands, since about 40% of all patients with this condition also manifest symptoms of hyperhidrosis (or excessive sweating). However recent reports have refuted this hypothesis due to non-involvement of sweat ducts.
What Causes Dyshidrotic Eczema?
There are certain factors that have found to be closely associated with this form of dermatitis,
- Contact dermatitis associated with sensitivity to nickel and cobalt is considered to be the primary trigger factor.
- Accidental ingestion of certain metals or metal poisoning is also linked with Dyshidrotic eczema.
- Genetics plays a vital role in the formation of dyshidrotic eczema.Mutation on one of the genes results in the loss of a structural protein which acts as a natural barrier on the skin to prevent water loss. This mutation results in dyskeratinization of the skin and increases water loss through the trans epidermal route.
- Fungal infection due to tenia pedis may also contribute to the formation of this form of eczema.
- Emotional stress is considered to be another important contributing factor which can trigger dyshidrotic eczema.
- Immunodeficiency disorders like HIV infection is also a risk factor for the development of this condition.
- Other causative factors include use of oral contraceptives, metal implants and cigarette smoking.
Dyshidrotic Eczema Symptoms
The symptoms of Dyshidirotic eczema comprise of the following,
- Formation of symmetrical vesicles of clear fluid on the palms and the fingers. These lesions may be present on the lateral aspect of the feet and toes.
- Vesicles are deep and have typical tapioca like appearance without the presence of surrounding erythema.
- Vesicles may eventually rupture resulting in desquamation.
- The condition may be associated with severe itching and occasional pain.
- Occasionally, these vesicles may get infected resulting in yellowish pustules. In long standing cases, the fingernails may be associated with dystrophic changes. Eventually cellulitis or lymphagnitis may develop following infection of the vesicles.
In about 80% of the cases only the hands are involved while 10% of the cases may be associated with involvement of only the feet. About 10% of the remaining cases may be associated with involvement of both the hands and feet.
Home Remedies For Dyshidrotic Eczema
Dietary correction plays a vital role in the management of dyshidrotic eczema, however there are certain other home remedies that might be considered valuable in the management of the condition,
- A low nickel diet is recommended in individuals suffering from nickel sensitivity. Avoiding foods like oysters, mushrooms, beans, asparagus, tomatoes, spinach, whole grain, tea, chocolate, cocoa and baking powder is recommended.
- In cobalt sensitive patients it is recommended to avoid foods contain cobalt namely beans, beets, cabbage, coffee, chocolate, tea, cloves, apricots, scallops, animal liver and whole grain.
- Avoiding sea food is also recommended, as it may be loaded with heavy metals and can lead to heavy metal poisoning.
- Homeopathic drugs namely graphitis and sulphur can aid in the rapid healing of the eczema. It is recommended to consume these drugs in low potency and should be repeated not more than twice a day.