Symptoms and causes

Symptoms

The blisters associated with dyshidrosis occur most commonly on the sides of the fingers and the palms. Sometimes the soles of the feet also can be affected. The blisters are usually small — about the width of a standard pencil lead — and grouped in clusters, with an appearance similar to tapioca.

In more-severe cases, the small blisters may merge to form larger blisters. Skin affected by dyshidrosis can be painful and very itchy. Once the blisters dry and flake off, which occurs in about three weeks, the underlying skin may be red and tender.

Dyshidrosis tends to recur fairly regularly for months or years.

When to see a doctor

Call your doctor if you have a rash on your hands or feet that doesn't go away on its own.

Causes

The cause of dyshidrosis is unknown. It can be associated with a similar skin disorder called atopic dermatitis, as well as with allergic conditions, such as hay fever. Eruptions may be seasonal in people with nasal allergies.

Risk factors

Risk factors for dyshidrosis include:

  • Stress. Dyshidrosis appears to be more common during times of emotional or physical stress.
  • Exposure to certain metals. These include cobalt and nickel — usually in an industrial setting.
  • Sensitive skin. People who develop a rash after contact with certain irritants are more likely to experience dyshidrosis.
  • Atopic eczema. Some people with atopic eczema may develop dyshidrotic eczema.

Complications

For most people with dyshidrosis, it's just an itchy inconvenience. For others, the pain and itching may limit the use of their hands or feet. Intense scratching can increase the risk of a bacterial infection developing in the affected skin.

April 30, 2016
References
  1. Wolff K, et al. Eczema/Dermatitis. In: Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com. Accessed Feb. 24, 2016.
  2. Adams DR, et al. Acute palmoplantar eczema (dyshidrotic eczema). http://www.uptodate.com/home. Accessed Feb. 24, 2016.
  3. Hand and foot dermatitis. Merck Manuals Professional Edition. http://www.merckmanuals.com/professional/dermatologic-disorders/dermatitis/hand-and-foot-dermatitis. Accessed March 4, 2016.
  4. Goldsmith LA, et al., eds. Vesicular palmoplantar eczema. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed March 4, 2016.
  5. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. March 17, 2016.