Vesicular palmoplantar eczema refers to itchy vesicular eruptions primarily affects hands and feet.
Clinical presentations range from acute to chronic disease patterns.
The disease may be divided into four categories:
Pompholyx
Subacute or chronic relapsing vesiculosquamous eczema
Chronic vesiculohyperkeratotic or hyperkeratotic eczema
Id reactions
All four types of vesicular palmoplantar eczema show dermatitis features like spongiosis and exocytosis histologically.
Sudden fluid-filled blisters appear with redness, itching, scaling, and discomfort present. Vesicular palmoplantar eczema specifically impacts the palms and soles causes discomfort.
Pompholyx, meaning “blister” in Greek includes vesicular and bullous forms causes severe blister eruptions on palms and soles.
The chronic hyperkeratotic variety thickens and fissures central palms that proves difficult to treat.
An Id reaction is a widespread eczematous eruption from a distal infection to presents as papulovesicular lesions on hands and feet.
All four types of vesicular palmoplantar eczema show dermatitis features despite varied presentations.
Epidemiology
Vesicular palmoplantar eczema frequency in U.S. unknown. Vesicular palmoplantar eczema likely accounts for 5-20% of hand eczema cases.
Dyshidrotic pattern was found in 14% of hand eczema cases studied. Vesicular palmoplantar eczema balanced ratio.
Pompholyx usually affects those aged 20-40 but can occur anytime.
Onset before age 10 is rare; recurrent pompholyx episodes decrease after middle age, unlike chronic vesicular and hyperkeratotic variants.
Anatomy
Pathophysiology
Vesicular palmoplantar eczema is often thought to have an unidentified intrinsic cause. Although many etiologic factors are described, the underlying pathology of vesicular palmoplantar eczema is unknown.
Study found that overexpression of aquaporin 3 and aquaporin 10 channels in the epidermis may have significant roles.
Certain triggers are linked to worsening symptoms like atopy and stress, but their exact role in flares remains unclear.
Vesicular palmoplantar eczema shows dermatitis with lymphocytic infiltrates present
Etiology
The causes of vesicular palmoplantar eczema are:
Genetic predisposition
Allergic triggers
Environmental factors
Stress
Infections
Genetics
Prognostic Factors
Mild palmoplantar eczema has excellent prognosis, while severe chronic forms require lifelong treatment and cause significant disability.
Acute vesicular eczema occurs sporadically and diminishes in frequency with increasing age.
Prognosis for subacute and chronic vesicular eczema is less satisfactory and often persists for years.
Clinical History
Collect details including the frequency of flares, onset, duration, potential triggers, and medical history to understand clinical history of patients.
Physical Examination
Palpation
Assessment of Severity
Systemic Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Drug-Induced Bullous Disorders
Epidermolysis Bullosa Acquisita
Irritant Contact Dermatitis
Lichen Planus
Scabies
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Various therapies exist for vesicular palmoplantar eczema with selection based on type and severity of condition.
Regularly use hand emollients and avoid irritants to prevent vesicular palmoplantar eczema flare-ups.
Contact allergy accounts for 67.5% of pompholyx eczema all patients should undergo patch testing for allergens.
High-potency glucocorticoids are first-line for palmoplantar eczema treatment.
Ointment preparations are less irritating to enhance drug delivery.
This method increases risk of secondary infections and corticosteroid side effects.
Mild vesicular palmoplantar eczema can be treated effectively with less potent corticosteroids.
Topical calcineurin inhibitors are as effective as mometasone furoate for chronic hand eczema.
Plantar eczema treatment may require alternative agents due to reduced effectiveness on soles compared to hands.
Use glucocorticoids or intralesional steroids for severe palmoplantar eczema if local therapy fails.
Aromatic retinoids like acitretin can control hyperkeratosis in hyperkeratotic eczema but should be used cautiously.
In the acute phase, the goal is to reduce inflammation, itching, and prevent blisters and minimize damage.
Pharmacologic therapy is effective in the treatment phase as it includes the use of corticosteroids, calcineurin inhibitors, retinoids, immunosuppressants, and chelators.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and interventional therapies.
The regular follow-up visits with the dermatologist are scheduled to check the improvement of patients along with treatment response.
Vesicular palmoplantar eczema refers to itchy vesicular eruptions primarily affects hands and feet.
Clinical presentations range from acute to chronic disease patterns.
The disease may be divided into four categories:
Pompholyx
Subacute or chronic relapsing vesiculosquamous eczema
Chronic vesiculohyperkeratotic or hyperkeratotic eczema
Id reactions
All four types of vesicular palmoplantar eczema show dermatitis features like spongiosis and exocytosis histologically.
Sudden fluid-filled blisters appear with redness, itching, scaling, and discomfort present. Vesicular palmoplantar eczema specifically impacts the palms and soles causes discomfort.
Pompholyx, meaning “blister” in Greek includes vesicular and bullous forms causes severe blister eruptions on palms and soles.
The chronic hyperkeratotic variety thickens and fissures central palms that proves difficult to treat.
An Id reaction is a widespread eczematous eruption from a distal infection to presents as papulovesicular lesions on hands and feet.
All four types of vesicular palmoplantar eczema show dermatitis features despite varied presentations.
Vesicular palmoplantar eczema frequency in U.S. unknown. Vesicular palmoplantar eczema likely accounts for 5-20% of hand eczema cases.
Dyshidrotic pattern was found in 14% of hand eczema cases studied. Vesicular palmoplantar eczema balanced ratio.
Pompholyx usually affects those aged 20-40 but can occur anytime.
Onset before age 10 is rare; recurrent pompholyx episodes decrease after middle age, unlike chronic vesicular and hyperkeratotic variants.
Vesicular palmoplantar eczema is often thought to have an unidentified intrinsic cause. Although many etiologic factors are described, the underlying pathology of vesicular palmoplantar eczema is unknown.
Study found that overexpression of aquaporin 3 and aquaporin 10 channels in the epidermis may have significant roles.
Certain triggers are linked to worsening symptoms like atopy and stress, but their exact role in flares remains unclear.
Vesicular palmoplantar eczema shows dermatitis with lymphocytic infiltrates present
The causes of vesicular palmoplantar eczema are:
Genetic predisposition
Allergic triggers
Environmental factors
Stress
Infections
Mild palmoplantar eczema has excellent prognosis, while severe chronic forms require lifelong treatment and cause significant disability.
Acute vesicular eczema occurs sporadically and diminishes in frequency with increasing age.
Prognosis for subacute and chronic vesicular eczema is less satisfactory and often persists for years.
Collect details including the frequency of flares, onset, duration, potential triggers, and medical history to understand clinical history of patients.
Palpation
Assessment of Severity
Systemic Examination
Drug-Induced Bullous Disorders
Epidermolysis Bullosa Acquisita
Irritant Contact Dermatitis
Lichen Planus
Scabies
Various therapies exist for vesicular palmoplantar eczema with selection based on type and severity of condition.
Regularly use hand emollients and avoid irritants to prevent vesicular palmoplantar eczema flare-ups.
Contact allergy accounts for 67.5% of pompholyx eczema all patients should undergo patch testing for allergens.
High-potency glucocorticoids are first-line for palmoplantar eczema treatment.
Ointment preparations are less irritating to enhance drug delivery.
This method increases risk of secondary infections and corticosteroid side effects.
Mild vesicular palmoplantar eczema can be treated effectively with less potent corticosteroids.
Topical calcineurin inhibitors are as effective as mometasone furoate for chronic hand eczema.
Plantar eczema treatment may require alternative agents due to reduced effectiveness on soles compared to hands.
Use glucocorticoids or intralesional steroids for severe palmoplantar eczema if local therapy fails.
Aromatic retinoids like acitretin can control hyperkeratosis in hyperkeratotic eczema but should be used cautiously.
Dermatology, General
Keep the environment at a comfortable to help prevent flare-ups. Use emollients before wearing gloves to protect the skin.
High humidity makes the skin feel moist and worsen symptoms for palm and sole involvement.
Wear breathable fabrics in hot weather to reduce sweating and discomfort.
Wear moisture-wicking and protective gloves to prevent direct contact with irritants and allergens.
Proper awareness about vesicular palmoplantar eczema should be provided and its related causes with management strategies.
Appointments with dermatologist and preventing recurrence of disorder is an ongoing life-long effort.
Dermatology, General
Betamethasone dipropionate:
It decreases inflammation to suppress the migration of polymorphonuclear leukocytes and reversing capillary permeability.
Clobetasol:
It suppresses mitosis and increases the synthesis of proteins to decrease inflammation.
Dermatology, General
Tacrolimus:
It suppresses the release of cytokines from T cells to inhibit transcription for genes.
Dermatology, General
Azathioprine:
It may decrease the proliferation of immune cells that results in low autoimmune activity.
Methotrexate:
It inhibits the enzyme dihydrofolate reductase is required for purine and pyrimidine synthesis.
Dermatology, General
Disulfiram:
It interferes with aldehyde dehydrogenase due to the chelating effect it is helpful to reduce the nickel burden.
Dermatology, General
Dupilumab:
It inhibits interleukin-4 and IL-13 signaling to bind the IL-4R-alpha subunit.
Dermatology, General
The procedures include intralesional steroid injections, phototherapy, wet wrap therapy, and cryotherapy.
Dermatology, General
In the acute phase, the goal is to reduce inflammation, itching, and prevent blisters and minimize damage.
Pharmacologic therapy is effective in the treatment phase as it includes the use of corticosteroids, calcineurin inhibitors, retinoids, immunosuppressants, and chelators.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and interventional therapies.
The regular follow-up visits with the dermatologist are scheduled to check the improvement of patients along with treatment response.
Vesicular palmoplantar eczema refers to itchy vesicular eruptions primarily affects hands and feet.
Clinical presentations range from acute to chronic disease patterns.
The disease may be divided into four categories:
Pompholyx
Subacute or chronic relapsing vesiculosquamous eczema
Chronic vesiculohyperkeratotic or hyperkeratotic eczema
Id reactions
All four types of vesicular palmoplantar eczema show dermatitis features like spongiosis and exocytosis histologically.
Sudden fluid-filled blisters appear with redness, itching, scaling, and discomfort present. Vesicular palmoplantar eczema specifically impacts the palms and soles causes discomfort.
Pompholyx, meaning “blister” in Greek includes vesicular and bullous forms causes severe blister eruptions on palms and soles.
The chronic hyperkeratotic variety thickens and fissures central palms that proves difficult to treat.
An Id reaction is a widespread eczematous eruption from a distal infection to presents as papulovesicular lesions on hands and feet.
All four types of vesicular palmoplantar eczema show dermatitis features despite varied presentations.
Vesicular palmoplantar eczema frequency in U.S. unknown. Vesicular palmoplantar eczema likely accounts for 5-20% of hand eczema cases.
Dyshidrotic pattern was found in 14% of hand eczema cases studied. Vesicular palmoplantar eczema balanced ratio.
Pompholyx usually affects those aged 20-40 but can occur anytime.
Onset before age 10 is rare; recurrent pompholyx episodes decrease after middle age, unlike chronic vesicular and hyperkeratotic variants.
Vesicular palmoplantar eczema is often thought to have an unidentified intrinsic cause. Although many etiologic factors are described, the underlying pathology of vesicular palmoplantar eczema is unknown.
Study found that overexpression of aquaporin 3 and aquaporin 10 channels in the epidermis may have significant roles.
Certain triggers are linked to worsening symptoms like atopy and stress, but their exact role in flares remains unclear.
Vesicular palmoplantar eczema shows dermatitis with lymphocytic infiltrates present
The causes of vesicular palmoplantar eczema are:
Genetic predisposition
Allergic triggers
Environmental factors
Stress
Infections
Mild palmoplantar eczema has excellent prognosis, while severe chronic forms require lifelong treatment and cause significant disability.
Acute vesicular eczema occurs sporadically and diminishes in frequency with increasing age.
Prognosis for subacute and chronic vesicular eczema is less satisfactory and often persists for years.
Collect details including the frequency of flares, onset, duration, potential triggers, and medical history to understand clinical history of patients.
Palpation
Assessment of Severity
Systemic Examination
Drug-Induced Bullous Disorders
Epidermolysis Bullosa Acquisita
Irritant Contact Dermatitis
Lichen Planus
Scabies
Various therapies exist for vesicular palmoplantar eczema with selection based on type and severity of condition.
Regularly use hand emollients and avoid irritants to prevent vesicular palmoplantar eczema flare-ups.
Contact allergy accounts for 67.5% of pompholyx eczema all patients should undergo patch testing for allergens.
High-potency glucocorticoids are first-line for palmoplantar eczema treatment.
Ointment preparations are less irritating to enhance drug delivery.
This method increases risk of secondary infections and corticosteroid side effects.
Mild vesicular palmoplantar eczema can be treated effectively with less potent corticosteroids.
Topical calcineurin inhibitors are as effective as mometasone furoate for chronic hand eczema.
Plantar eczema treatment may require alternative agents due to reduced effectiveness on soles compared to hands.
Use glucocorticoids or intralesional steroids for severe palmoplantar eczema if local therapy fails.
Aromatic retinoids like acitretin can control hyperkeratosis in hyperkeratotic eczema but should be used cautiously.
Dermatology, General
Keep the environment at a comfortable to help prevent flare-ups. Use emollients before wearing gloves to protect the skin.
High humidity makes the skin feel moist and worsen symptoms for palm and sole involvement.
Wear breathable fabrics in hot weather to reduce sweating and discomfort.
Wear moisture-wicking and protective gloves to prevent direct contact with irritants and allergens.
Proper awareness about vesicular palmoplantar eczema should be provided and its related causes with management strategies.
Appointments with dermatologist and preventing recurrence of disorder is an ongoing life-long effort.
Dermatology, General
Betamethasone dipropionate:
It decreases inflammation to suppress the migration of polymorphonuclear leukocytes and reversing capillary permeability.
Clobetasol:
It suppresses mitosis and increases the synthesis of proteins to decrease inflammation.
Dermatology, General
Tacrolimus:
It suppresses the release of cytokines from T cells to inhibit transcription for genes.
Dermatology, General
Azathioprine:
It may decrease the proliferation of immune cells that results in low autoimmune activity.
Methotrexate:
It inhibits the enzyme dihydrofolate reductase is required for purine and pyrimidine synthesis.
Dermatology, General
Disulfiram:
It interferes with aldehyde dehydrogenase due to the chelating effect it is helpful to reduce the nickel burden.
Dermatology, General
Dupilumab:
It inhibits interleukin-4 and IL-13 signaling to bind the IL-4R-alpha subunit.
Dermatology, General
The procedures include intralesional steroid injections, phototherapy, wet wrap therapy, and cryotherapy.
Dermatology, General
In the acute phase, the goal is to reduce inflammation, itching, and prevent blisters and minimize damage.
Pharmacologic therapy is effective in the treatment phase as it includes the use of corticosteroids, calcineurin inhibitors, retinoids, immunosuppressants, and chelators.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and interventional therapies.
The regular follow-up visits with the dermatologist are scheduled to check the improvement of patients along with treatment response.
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