Dyshidrotic eczema refers to a recurrent eczematous disorder of the hands and feet commonly seen in older children and adults; it is often seen in association with hyperhidrosis (excessive sweating).
Patients have multiple small, intensely pruritic (itchy) vesicles on the palm of the hands, soles or digits. Maceration (softening and breaking down of the skin) and secondary infection are common due to severe pruritis (itching). Patients may also have nail problems, including onycholysis (loosening or separation of a fingernail or toenail from its nail bed), yellowing and pitting of the nails. A subset of patients also have atopy (a history of atopic dermatitis, allergies/hay fever, and/or asthma), and it is unclear whether this represents an isolated disorder or a variant of eczema.
Dyshidrotic eczema may be confused with allergic contact dermatitis, although the latter tends to affect top side of the hands rather than the palms. Treatment is similar to that for acute atopic dermatitis (topical corticosteroids and lubricant), but the dermatitis may be persistent even with good therapy.