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Pompholyx

Pompholyx is a very common type of hand eczema and literal meaning of this is the bubble. In pompholyx person notices development of extremely itchy, uncomfortable tough blisters on hands and feet. Most of the times these blisters start developing on the sides of fingers and in severe cases involve palm or entire soles.


There are other names which are used for pompholyx such as

 

  1. Dyshidrosis

  2. Dyshidrotic eczema

  3. Cheiropompholyx ( hand)

  4. Pedopompholyx ( feet)

  5. Vesicular endogenous eczema

 

 

Associations of pompholyx or dyshidrotic eczema
Pompholyx is very commonly seen

 

  1. People having atopic dermatitis

  2. Personal or family history of pompholyx in past. This is present in 50 % individual

  3. Hyperhidrosis or excessive sweating in palms and soles

  4. Emotional stress

  5. Metal allergies

 

 

Symptoms of pompholyx
In dyshidrotic eczema usually, the symmetrical affection of palms and soles happens.

 

  1. Start of symptoms is many times with several hours of itching and burning sensation in palm, soles or both.

  2. initially, 1-2mm diameter vesicles along sides of fingers and toes start coming.

  3. Later on, small vesicles merge to form larger blisters and similar blisters on palms and soles appear.

  4. A lot of patients also have redness on palms and soles along with constant wetness

  5. Scaling and peeling on palms and soles happen later on due to merging and deroofing of blisters.

  6. Many Waves of itchy blisters on palms within a sin gle episode is also common due to repeat damage before complete healing.

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Investigations and diagnosis of dyshidrotic eczema or pompholyx
Usually, diagnosis is made by clinical examination. Your dermatologist can diagnose it by looking at the lesions and taking a thorough history. In rare cases; you may be advised biopsy or patch testing. These additional investigations are done to find the cause of pompholyx in nonresponsive to treatment cases.


Treatment of Pompholyx

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  1. For oozing lesions, some .edicated soaks are advised.

  2. Drainage of large blisters if needed

  3. Antibiotics in case of secondary infections

  4. Topical or oral steroids to subside the acute episode of dyshidrotic eczema

  5. Light-based therapies

  6. Botulinum toxin ( Botox) injections may be needed in some severe cases

  7. Iontophoresis

  8. Immunomodulator or immunosuppressive therapies topical or oral in severe cases.

  9. Radiotherapy has also been rarely utilized.

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