Dyshidrotic eczema on the fingers
Dyshidrotic eczema on the fingers is an eczematous dermatitis of the skin of the palms, which is chronic in nature and manifests itself in the form of small blisters filled with serous contents.
Dyshidrotic eczema in 80% of cases affects the skin of the palms, the soles account for the remaining 20%. The disease got its name due to the fact that earlier scientists associated its occurrence with a blockage of the glands of sweat secretion. Modern medicine has a different view of this problem and dyshidrotic eczema on the fingers is explained by other reasons, since it has been proven that the sweat glands function normally in most patients. If we consider this disease in the general structure of dermatological pathologies, then it is observed in about 8% of patients.
The disease is diagnosed in both men and women with the same frequency. However, the age at which dyshidrotic eczema affects women most often varies between 20-25 years, while among men the disease occurs more often around the age of 40. In children, pathology is rarely found. There is evidence that people living in cities are more likely to develop eczema than people living in rural areas.
Content:
- Symptoms of dyshidrotic eczema on the fingers
- Causes of dyshidrotic eczema on the fingers
- Diagnostics of the dyshidrotic eczema on the hands
- Treatment of dyshidrotic eczema on the hands
Symptoms of dyshidrotic eczema on the fingers
Symptoms of dyshidrotic eczema on the fingers are as follows:
- Elements of a rash appear on the skin of the fingers, which look like vesicles. These are small vesicles with transparent serous contents, their size does not exceed 0.5 cm. A solid cover forms on the surface of the vesicle.
- The vesicles are located deep in the epidermal layer of the skin. Severe itching precedes and accompanies the formation of vesicles.
- Primary elements arise on the lateral surfaces of the fingers. Subsequently, the rashes are combined into groups, covering the palmar and dorsal surfaces of the hands.
- As the disease progresses, the bubbles resolve, forming erosion. Erosions are larger than the vesicles themselves and tend to fuse after opening. The opening process takes place both independently and due to the combing of the bubbles.
- Over time, erosion heals, and yellowish crusts form on their surface, which can sometimes have a brownish tint.
- Subsequently, skin changes characteristic of eczema are observed: it begins to peel off, thickens, turns red, the skin pattern intensifies, and cracks form on it.
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If pathogenic mycobacteria get into the cracks, then a microbial infection joins. Secondary infection is accompanied by purulent inflammation, called pyoderma. In this case, purulent pustules form on the skin. Accordingly, a violation of the general condition of the patient occurs, the body temperature rises, the affected areas of the dermis swell and hurt, the regional lymph nodes increase in size.
- Most often, dyshidrotic eczema has a chronic course with characteristic phases of remission and exacerbation. The duration of the exacerbation period is several weeks.
Causes of dyshidrotic eczema on the fingers
It has been established that the causes of dyshidrotic eczema of the fingers are:
- Endocrine diseases (diseases of the thyroid gland, hypothalamic-pituitary system, adrenal glands, dysfunction of the gonads).
- Diseases of the nervous system. Many patients note that the appearance of dyshidrotic eczema was preceded by a strong nervous tension.
- Metabolic disorders.
- Violations in the functioning of the immune defense.
- Contact of the skin of the hands with irritating substances can provoke the disease. These are most often the various household chemicals.
- Hyperhidrosis also contributes to the development of a dyshidrotic form of eczema, when the disease manifests itself due to excessive work of the sweat glands on the palms. Hyperhidrosis often occurs against the background of lability of autonomic nervous regulation, or with impaired functioning of the endocrine glands.
- The connection of this skin pathology with food allergy is not excluded. So, on average, 50% of patients are simultaneously diagnosed with bronchial asthma, atopic dermatitis, hay fever. Moreover, there is a hereditary predisposition to such allergic diseases, and they can be traced in the anamnesis of the closest relatives.
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Occupational hazards often become the cause of the development of the disease, when a person at work is forced to deal with various irritating substances. In this regard, the risk group includes cleaners, employees of chemical enterprises, washers, plasterers, painters, car service workers and other employees who have regular contact with aggressive substances.
- Irrational intake and use of medicines.
- Burns, abrasions, abrasions, hypothermia can become a trigger for the development of dyshidrotic eczema.
- Infectious diseases reduce the body's immune defenses and can be indirect causes of the development of dyshidrotic eczema.
- Less commonly, the disease develops due to exposure to the skin of the hands of solar radiation.
It is worth noting that up to 22% of all cases of this type of eczema remain with an unexplained etiology, that is, the cause cannot be established. You should not be afraid of the transmission of dyshidrotic eczema by contact or in any other way, this disease is not contagious.
Diagnostics of the dyshidrotic eczema on the hands
There are no specific diagnostic techniques aimed at detecting dyshidrotic eczema. However, this does not mean that you should not seek the advice of a specialist. The doctor will assess the clinical picture, the place of localization of the rash and will be able to make a preliminary diagnosis. The chronic course of the disease with frequent relapses will only confirm this assumption.
In addition, differential diagnosis is important, which makes it possible to distinguish this type of eczema from other forms of the disease, with mycotic lesions, contact dermatitis, and palmar-plantar psoriasis. Therefore, the specialist sends the patient to the delivery of scrapings for pathogenic fungi, then the sowing of the separated contents of erosion, or the serous contents of vesicles is carried out. This allows us to confirm that the disease is not of a primary infectious nature, and if a secondary infection has joined, then it becomes possible to choose the right treatment.
It is strongly discouraged to diagnose yourself and even more so to start treatment without visiting a specialist. In addition to the fact that the course of the disease can be aggravated, such self-activity can lead to a distortion of the clinical picture characteristic of dyshidrotic eczema. This, in turn, can lead to medical error and inappropriate therapy.
Dyshidrotic eczema is differentiated from mycosis of the skin of the hands exclusively in laboratory conditions. A combination of two types of disease in one patient is not excluded.
Treatment of dyshidrotic eczema on the hands
Treatment of dyshidrotic eczema on the hands will be successful only if the patient is treated individually. There are many methods of dealing with the disease, but it is important to choose one that will directly affect the cause of its occurrence.
Before starting therapy, the doctor detects and eliminates all foci that could serve as provoking factors. These are the scars left after the injuries, chronic diseases, diseases of the nervous sphere, pathology of internal organs. You should also get rid of external factors that could cause the disease.
So, the beginning of therapy should be based on the identification and elimination of such pathological conditions as:
- Diseases of the central nervous system;
- Disruptions in neuro-vegetative regulation;
- Malfunctions of the digestive tract;
- Hormonal dysfunctions;
- Disruptions in the excretory system;
- Immune disorders
- Metabolic disorders.
Therapy should be comprehensive, with emphasis on both the treatment of skin manifestations and the elimination of dysfunctions of the body as a whole. The selection of course therapy is based on the presence or absence of pyoderma, on the appearance of the rash. Skin manifestations with successful treatment should be completely eliminated.
To do this, appoint:
- Sedatives and anti-allergic drugs. Sedatives are prescribed to help normalize the patient's sleep. Antihistamines allow you to cope with itching, relieve allergic manifestations. For this, agents such as: Erius, Cetrin, Zyrtec, Suprastin, Tavegil, parenteral administration of calcium preparations can be prescribed.
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Topical preparations. If eczema is accompanied by a symptom of wetness and pyoderma, then every 20 minutes it is shown to apply lotions with boric acid at a concentration of 1-2%, with tannin, resorcinol at a concentration of 0.25%, with silver nitrate or furacilin.
With dyshidrotic eczema, several external drugs are not prescribed at once, since some patients have hypersensitivity to most drugs. If an intolerance arises, then it will be quite problematic to determine which remedy it has a reaction to. In addition, ointments are applied to a small area of the skin, if inflammation does not occur, then it is used throughout the affected area.
The following non-hormonal ointments for eczema and topical antiallergenic agents are used:
- Radevit,
- Eplan,
- Gistan,
- Elidel,
- Naftaderm,
- Fenistil,
- Losterin,
- Timogen,
- Destin,
- Isis,
- Solcoseryl,
- We see
- D-panthenol.
Antibacterial ointments are used only if the disease is complicated by a secondary infection. These drugs include: Levosin, Fucidin, Bactroban, Lincomycin, Gentamicin, Erythromycin ointment. Miramistin and Chlorhexidine can be used as antiseptic solutions.
Ointments based on corticosteroid hormones are advised to be used only against the background of painful cracks and erosion. Pulse therapy with similar agents is recommended, since their prolonged application can provoke the development of side effects, up to tissue atrophy.
- Physiotherapy treatments. Physiotherapy for dyshidrotic eczema on the hands is widely used. Methods such as: ultrasound therapy, laser and magnetic therapy, thalassotherapy, darsonvalization, acupuncture, electrosleep - all of them help to strengthen the immune system, reduce the amount of drugs used. Doctors strongly recommend that their patients relax in sanatoriums and resorts, take mineral, hydrogen sulfide, mud, radon, salt baths.
- Taking vitamins. With a dyshidrotic form of eczema, it is recommended to take vitamins A, E, group B. Perhaps the appointment of vitamin complexes.
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Prevention of external influences on the skin of the hands. If the patient has to come into contact with chemicals, it is imperative to protect hands with rubber gloves, and it is best to wear cotton gloves under them. This will prevent excess moisture and skin maceration.
The best way to wash your hands is baby soap, or specialized hypoallergenic products. Bed linen and underwear should be rinsed thoroughly so that no traces of powder remain on it.
- Compliance with a diet. An important rule that is used when compiling a menu is to eliminate all potential allergens from the diet. It is worth reducing the amount of salt, excluding semi-finished products, as well as food containing a large amount of easily digestible carbohydrates: sugar, honey, baked goods, confectionery. Eggs, strawberries, citrus fruits, chocolate, etc. are eaten with caution.
The patient may need the help of a psychologist to cope with the psychological discomfort caused by the illness.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
