Acute Palmoplantar Eczema: Causes, Diagnosis, and Treatment

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Eczema is a chronic inflammatory skin condition that can cause itchiness, skin inflammation, and dryness all over your body. The condition, sometimes referred to as atopic dermatitis, is often triggered by some type of allergy or irritation.

There are many types of eczema. One of the ways the different types are grouped is by the part of the body most affected.

Palmoplantar eczema is a specific type of eczema that targets the hands and sometimes the feet. Other names for the condition include:

  • acute palmoplantar eczema
  • chieropompholyx
  • dyshidrosis
  • dyshidrotic dermatitis
  • foot-and-hand eczema
  • pedopompholyx
  • pompholyx
  • vesicular eczema
  • vesicular palmoplantar eczema

Learn about what causes this condition, what it looks like, and what to expect if you develop this type of eczema.

Like other forms of eczema, acute palmoplantar eczema develops with some level of skin irritation.

The main feature of this type of eczema is the appearance of deep, fluid-filled blisters, referred to as a vesicular rash. The appearance of this rash is sometimes compared to tapioca pudding.

In addition to this blistered appearance, acute palmoplantar eczema can develop with symptoms like:

  • intense burning
  • itching
  • peeling skin
  • red, dry cracks in the skin
  • pain
  • swelling

Researchers believe there are likely many reasons that eczema develops, and it’s difficult to pinpoint an exact cause. Some common themes in people with acute palmoplantar eczema include:

Outside of the underlying cause, it’s also important to note that many forms of eczema flare up in the presence of certain triggers. Triggers of acute palmoplantar eczema can include things like:

  • hot weather
  • sweating
  • humidity
  • skin irritation from friction, chemicals, or detergents
  • frequent handwashing
  • stress

Acute palmoplantar eczema develops with skin irritation and the appearance of deep, fluid-filled blisters. The appearance of the skin rash has sometimes been compared to tapioca pudding.

The common complications of palmoplantar eczema are secondary skin infections. These can be fungal or bacterial infections that require additional medications like antibiotics.

If you have a flare-up that doesn’t go away or severe blisters, you may need more intensive treatment.

People who develop acute palmoplantar eczema often have a history of this condition in their family. Even a personal or family history of other forms of eczema can increase your risk of developing the acute palmoplantar variety by about 50 percent.

It’s more common in women than in men, and is more common before age 40. This condition is also more common in people with overactive sweat glands on the palms of their hands (palmoplantar hyperhidrosis) and in people who smoke tobacco.

Topical medications are commonly used for the treatment for acute palmoplantar eczema, and this can include using:

A doctor may also recommend either an over-the-counter or prescription anti-itch cream.

Treatment is usually guided by how severe your symptoms are. More advanced cases of palmoplantar eczema could require additional medications like:

Most people tend to visit their doctor for this condition when home remedies like creams and lotions have not cleared their irritation.

If you receive a diagnosis of acute palmoplantar eczema, be sure to follow up with your doctor if your flare-up doesn’t improve in 1 to 2 weeks. This could be a sign of a secondary infection or some other complication.

The first step in diagnosing acute palmoplantar eczema is usually a clinical examination. A primary care doctor may be able to do this exam, but you could also be referred to a dermatologist (skin specialist) or an allergist.

The examination is usually a physical exam. This condition is often diagnosed on appearance and symptoms alone.

In some cases, a doctor may perform a biopsy, taking a small piece of tissue for testing, but this is less common. Skin scrapings and biopsies may be used to rule out other complications like bacterial or fungal infections.

There are some steps you can take that may help reduce eczema flare-ups. In some cases, avoidance of irritants or allergens can help.

Some steps you can take to care for your skin and reduce the likelihood of flare-ups and complications include:

  • removing rings and other jewelry where moisture can get trapped against your skin
  • moisturizing your hands and feet well and often
  • using lukewarm water and mild, unscented soaps when washing your skin
  • learning to manage stress
  • taking care to avoid excessively dry, humid, or hot conditions
  • wearing protective gloves
  • not scratching an active rash

Acute palmoplantar eczema is a type of chronic skin condition that can affect the palms of the hands and soles of the feet. This type of eczema can lead to the formation of fluid-filled blisters and a red, peeling, painful rash. Speak with a doctor about possible triggers for your condition and how best to avoid and manage flare-ups.

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