pompholyx

汗疱

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/03/12 02:26:11」(JST)

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Dyshidrosis / Dyshidrotic eczema / Pompholyx
Classification and external resources
The characteristic vesicles of dyshidrosis on a finger
ICD-10	L30.1
ICD-9	705.81
DiseasesDB	10373
MedlinePlus	000832
eMedicine	derm/110 ped/1867
MeSH	D011146

Dyshidrosis (also known as "acute vesiculobullous hand eczema," "cheiropompholyx," "dyshidrotic eczema," "pompholyx," and "podopompholyx") is a skin condition that is characterized by small blisters on the hands or feet. It is an acute, chronic, or recurrent dermatosis of the fingers, palms, and soles, characterized by a sudden onset of many deep-seated pruritic, clear vesicles; later, scaling, fissures and lichenification occur. Recurrence is common and for many can be chronic. Incidence/prevalence is said to be 1/5,000 in the United States. However, many cases of eczema are diagnosed as garden-variety atopic eczema without further investigation, so it is possible that this figure is misleading.

This condition is not contagious to others, but the compromised integument can increase susceptibility to infection, and the accompanying itching can be a source of psychological duress.

The name comes from the word "dyshidrotic," meaning "bad sweating," which was once believed to be the cause, but this association is unproven; there are many cases present that have no history of excessive sweating. There are many different factors that may trigger the outbreak of dyshidrosis such as allergens, physical and/or mental stress, or seasonal changes.

Symptoms

Small blisters with the following characteristics:

• Blisters are very small (3 mm or less in diameter). They appear on the tips and sides of the fingers, toes, palms, and soles.
• Blisters are opaque and deep-seated; they are either flush with the skin or slightly elevated and do not break easily. Eventually, small blisters come together and form large blisters.
• Blisters may itch, cause pain, or produce no symptoms at all. They worsen after contact with soap, water, or irritating substances.
• Scratching blisters breaks them, releasing the fluid inside, causing the skin to crust and eventually crack. This cracking is painful as well as unsightly and often takes weeks, or even months to heal. The skin is dry and scaly during this period.
• Fluid from the blisters is serum that accumulates between the irritated skin cells. It is not sweat as was previously thought.
• In some cases, as the blistering takes place in the palms or finger, lymph node swelling may accompany the outbreak. This is characterised by tingling feeling in the forearm and bumps present in the arm pits.
• Nails on affected fingers, or toes, may take on a pitted appearance.

• Advanced stage of dyshidrosis on the fingers

• Palmar dyshidrosis

• Advanced stage of palmar dyshidrosis on the palm showing cracked and peeling skin

• Advanced stage of dyshidrosis on the foot.

• Rim of scale on the palmar surface of the thumb from a resolving dyshidrotic flare

Causes

Causes of dyshidrosis are unknown. However, a number of triggers to the condition may include:

• Allergic reactions of various kinds, including allergies to nickel which is present in many foods and vitamins (i.e. oatmeal, canned foods).
• A randomized, double-blind, placebo-controlled cross-over study by the University Medical Center Groningen reported that dishydrosis outbreaks on the hands increased significantly among those allergic to house dust mites, following inhalation of house dust mite allergen.

Treatment

There are many treatments available for dyshidrosis. However, few of them have been developed or tested specifically on the condition.

• Topical steroids - while useful, can be dangerous long-term due to the skin-thinning side-effects, which are particularly troublesome in the context of hand dyshidrosis, due to the amount of toxins and bacteria the hands typically come in contact with.
• Potassium permanganate dilute solution soaks - also popular, and used to 'dry out' the vesicles, and kill off superficial Staphylococcus aureus, but it can also be very painful. Undiluted it may cause significant burning.
• Dapsone (diamino-diphenyl sulfone) is an antibacterial sulfonamide. It has been recommended for the treatment of dyshidrosis in some chronic cases.
• Antihistamines: Fexofenadine up to 180 mg per day.
• Alitretinoin (9-cis-retinoic acid) has been approved for prescription in the UK. It is specifically used for chronic hand and foot eczema. It is made by Basilea of Switzerland (BAL 4079).
• In the case of a nickel allergy or sensitivity a low nickel diet may lead to improvement. This includes avoiding high nickel foods like oatmeal and chocolate, canned foods (especially acidic foods like pineapple and tomato that leach metal from the can), and using vitamins that do not contain nickel. In this situation avoiding excessive exposure to environmental nickel may also be helpful, such as not using stainless steel pots and silverware.

See also

• List of cutaneous conditions
• Dermatology
• Epidermolysis bullosa - a genetic disorder that causes similar, but more severe, symptoms to dyshidrosis

References

External links

Wikimedia Commons has media related to Category:Dyshidrosis.

• Dyshidrotic eczema at MedlinePlus
• Images of dyshidrotic eczema at Skinsight
• MedAdvice.com
• Pompholyx at DermNet NZ (New Zealand Dermatological Society Incorporated)
• Information, advice and shared experiences for Pompholyx sufferers

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 急性掌蹠湿疹（異汗性湿疹） acute palmoplantar eczema dyshidrotic eczema
• 2. 皮膚の水疱を有する患者に対するアプローチ approach to the patient with cutaneous blisters
• 3. 皮膚炎の概要 overview of dermatitis
• 4. 成人における刺激性接触皮膚炎 irritant contact dermatitis in adults
• 5. 水疱性類天疱瘡および粘膜類天疱瘡の臨床的特徴および診断 clinical features and diagnosis of bullous pemphigoid and mucous membrane pemphigoid

English Journal

• Diagnosing chronic hand eczema by an algorithm: a tool for classification in clinical practice.

• Molin S, Diepgen TL, Ruzicka T, Prinz JC.SourceDepartment of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany. sonja.molin@med.uni-muenchen.de
• Clinical and experimental dermatology.Clin Exp Dermatol.2011 Aug;36(6):595-601. doi: 10.1111/j.1365-2230.2010.04001.x.
• BACKGROUND: Diagnostic classification of chronic hand eczema (CHE) represents a major clinical and taxonomic challenge because of its wide aetiological and clinical heterogeneity.AIM: To develop an algorithm for the diagnosis and classification of CHE.METHODS: Well-defined aetiological, clinical and
• PMID 21771004

• A systematic approach to systemic contact dermatitis and symmetric drug-related intertriginous and flexural exanthema (SDRIFE): a closer look at these conditions and an approach to intertriginous eruptions.

• Winnicki M, Shear NH.SourceDepartment of Dermatology, Sunnybrook Hospital, University of Toronto, Ontario, Canada. monika.winnicki@gmail.com
• American journal of clinical dermatology.Am J Clin Dermatol.2011 Jun 1;12(3):171-80. doi: 10.2165/11539080-000000000-00000.
• Systemic contact dermatitis is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular
• PMID 21469762

Japanese Journal

• Dyshidrosiform Pemphigoidの1例

• 山田 陽子,杉田 和成,伊豆 邦夫 [他]
• 産業医科大学雑誌 33(2), 183-187, 2011-06-01
• NAID 40018874965

• 月1回免疫グロブリン少量静注療法が副作用をおさえ寛解維持に有効であった多巣性運動ニューロパチーの1例

• 村田 佳子,岡本 智子,近土 善行,千原 典夫,古澤 嘉彦,村田 美穂
• 臨床神経学 50(8), 561-565, 2010-08-01
• NAID 10027705615

Related Links

• Pompholyx (dyshidrotic eczema, vesicular hand eczema). DermNet NZ

24 Jul 2012 ... Pompholyx (dyshidrotic eczema, vesicular hand eczema). Authoritative facts about the skin from the New Zealand Dermatological Society.

Related Pictures

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★リンクテーブル★

リンク元

「異汗性湿疹」

「異汗性湿疹」

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英

dyshidrotic eczema

同

汗疱 pompholyx

• アトピー皮膚炎患者では出やすいらしい