What is Pompholyx?
Picture 1 – Pompholyx Image
Source – avicenna
The term Pomphlolyx is a Greek derivative which means a bubble. It is a kind of skin eczema that is characterized by the occurrence of small itchy blisters on the hands and the feet. It also causes the inflammation and the drying up of the skin, thereby causing irritation. It is usually caused by seasonal changes, stress factors or allergens. It is also known as Dyshidrosis, Dyshidrotic eczema pompholyx, Dyshiodrotic dermatitis, and Vesicular eczema. The name Dyshidrotic literally means one who sweats too badly. Specifically, Pompholyx hand eczema is known as Cheiropompholyx and pompholyx feet eczema is known as Pedopompholyx. It may be of an acute or chronic type depending upon the nature of eczema that one is affected with. Problems such as scaling, fissure formation and lichenification occur in case of pompholyx. Although pompholyx hand or feet eczema is not contagious in nature but it may be a significant cause of social embarrassment. It is common among people of all ages but it has specifically been found to affect mostly beings of the feminine gender.
Symptoms of Pompholyx
Pompholyx is signaled by the formation of tiny blisters or vesicles on the hands and feet. The blisters usually occur on the sides of the fingers or on the palms. In the feet it is usually seen to affect the toes and the soles. The vesicles may cause itching and burning sensation. The blisters are deep-seated in nature and do not have the tendency to burst or break until and unless triggered by an external force or a substance that is most likely to cause infection and irritation such as soap, water, etc. Eventually, the tiny blisters acquire the tendency to merge together to give rise to blisters which are obviously greater in shape and size. The blisters contain a fluid known as serum which accumulates in the skin cells which are affected. Any kind of scratching of the blisters may cause the blister to turn red and swell and form crust and crack. Normally, the skin cracks or peels once the blisters are on the process of healing. But the process of cracking is painful. In case of severe dyshidrosis or pompholyx, the finger nails or the toe nails may develop ridges and may cause swelling, a condition known as Paronychia. The swelling associated with pompholyx is actually the swelling of lymph nodes of the palms and the feet. It is mostly known to affect people who are allergic in nature and may also suffer from asthma and other respiratory problems.
It has still not been possible for doctors and scientists to exactly discern dyshidrosis causes but a number of conditions are supposed to trigger the disease which are enumerated as the following:-
- Excessive sweating is supposed to be one of the causes for pompholyx which is noticed in cases when one suffers from anxiety, frustration or stress related problems. Sweating is believed to trigger vesicular eruption that is a characteristic of pompholyx eczema.
- Fungal infections like the Athlete’s foot are one of the most common causes of pompholyx that causes vesicular eruption and discharge of pus.
- Allergic agents such as carbonated and alcoholic beverages, food items high in nickel and caffeine content and also dairy products may just not cause but also intensify pompholyx eczema and pompholyx dermatitis. Some of the items that fall within the purview of such allergic irritants are cocoa, chocolate, soy, butter and cheese, etc. Allergies may also be caused by contact with Cr (6+) compounds such as Potassium dichromate, other leather preservative may also lead to pompholyx. Dust mite allergies may also be the cause behind dishydrosis.
- Prolonged exposure to sunlight may lead to skin disorders of several types including pompholyx.
- It has also been observed that people who are exposed to chlorinated water, antibacterial soaps contribute to intensifying pompholyx. As is also common with all kind of skin eczemas, antibacterial soaps, deodorants and fragrances, and its contact with fresh meat and fresh fruit juices may aggravate the situation.
- Damp conditions may trigger the outbreak of pompholyx. Certain kinds of fabrics such as nylon and synthetic types are known to encourage dyshidrosis.
- Dermatitis of all kinds such as Seborrheic and Atopic may also be the reason behind the occurrence of pompholyx.
- Immune problems such as Ulcerative colitis, Inflammatory Bowel Disease, and Crohn’s Disease are also known to exacerbate pompholyx.
Diagnosis of Pompholyx
One can diagnose dyshidrosis by undergoing an allergy test where the suspected substances are applied or brought close to the body to observe if the substances actually trigger a reaction. It is best to go for an allergy test for the entire body, medically known as Alcat to determine an allergic reaction that has caused pompholyx as one of its effects.
Pictures of Pompholyx
Check out these pompholyx pictures to know more about the disease.
Pompholyx (Dyshidrosis) Treatment
Since the exact cause of pompholyx is unknown, so there are no particular dyshidrosis or pompholyx eczema treatment but in fact many, all of this does not guarantee an absolute cure for pompholyx. Some of the different kinds of treatments for pompholyx are mentioned as the following:-
- Compressing the affected area with cold or wet compresses for about 15 minutes more than thrice or four times a day help in the fast and effective healing of pompholyx.
- Topical steroids can help in reducing inflammation of the skin that is a characteristic feature of dyshidrosis. By helping to reduce inflammation, it also provides relief from the irritation and facilitates the process of healing. They are available in the form of creams such as Lotrisone and others containing Clotrimazole, Betamethasone and Dipropionate, ointment such as the zinc oxide ointments or tablets. But they must be avoided for a long term use since they have strong side-effects which may be extremely for the body.
- Medicines available over the counter (OTC) such as domeboro which contains aluminum acetate and other OTC antistringent help in drying up of the blisters and fastens the healing of dyshidrosis. Medications and drugs such as Efalizumab, Ciclosporin, Clobetasol Propionate are quite helpful in the treatment for pompholyx induced by ulcerative colitis. One has to soak the pompholyx affected area in Borows or Domeoboro solution for atleast half an hour more than once a day. A dilute solution of potassium permanganate is more helpful in drying the pompholyx vesicles and causing destruction of the superficial viral or bacterila agents causing the same. Severe pompholyx or dyshidrosis can be treated with Immunodulators like Pimecrolimus and Tacrolimus that help in preventing organ rejection.
- Chronic pompholyx can be treated with antibacterial sulfonamide such as Dapsone.
- During the dry phase of dyshidrosis, emollients can help in the cracking process and reduces the itching associated with it. Filing the fissures with an emery board helps in minimizing pompholyx.
- A more natural way of treating pompholyx is to keep the palms and the feet immersed in a solution of salt for atleast half an hour which must be carried on for a minimum of 3-4 days or more. One may also soak the affected feet or hands in a solution containing white vinegar. This is the best pompholyx home treatment. One can also treat it at home using Plantain infused in olive, lavender or other kinds of oil.
- In cases when pompholyx is highly associated with itching, the application of hemp oil or vaseline petroleum jelly can provide some relief.
- One may wear unbleached cotton gloves for covering the hands to prevent the area from getting scratched and making it less prone to bacterial or viral agents which are responsible for causing infection.
- One can clear up the pompholyx blisters and soothe itching with the help of surgical spirit or alitretinon 9-cis-retinoic acid such as Toctino in case of chronic pompholyx.
- Soaps which contain Sodium Laureth Sulfate must be strictly avoided as it is known to exacerbate the infection. It is advisable to apply aloe vera to the affected area after cleaning them.
- One may also go for a Light Therapy to treat Dyshidrosis which are available in a varied form such as PUVA therapy, the UVA-1, the Low Level Light Therapy, UVB therapy and also the Grenz ray therapy. In such cases the skin is put under a solution of psoralen before exposing it to sunrays.
However, the best way to treat pompholyx or dyshidrosis is to maintain ones personal hygiene and addressing the dietary needs which prevents the intake of alcoholic and addictive substance which may induce pompholyx. One may go for stress management counseling to prevent the supposed cause of most of the cases of dyshidrosis. In order to prevent further pompholyx complications, one must be under the supervision of dermatologists. But, pompholyx is of a recurrent nature and if not treated well may recur. So, an effective treatment is necessary for pompholyx but nothing ensures an absolute cure.