Pompholyx

Pompholyx
(Dyshidrotic eczema)
It is vescular eczema with chronic and recurrent lesions affecting especially the palms and soles. Here the oedema fluid accumulates to form visible vesicles or bullae. Because of the thick epidermis in these sites, the blisters tend to become larger than in other body areas before they burst.
This condition was also called dyshidrotic eczema due to its supposed ( though false) connection with sweat gland activity, since it is known to get worse in the hot weather.
Causes are hereditary predisposition to this disorder. Stress is also known to play a role in causing and being a result of this skin disorder.
Fully formed lesions show the changes of acute eczema modified the thick, overlying epidermis. The subsequent course is that of a subsiding eczema with hyperkeratosis and epidermal shedding.
Pompholyx is seen to specially affect adults before 40 years of age. But rarely in children below 10 years of age.
There is sudden onset of crops of clear deep seated, sago like, usually symmetrical vesicles, with intense itching. There is no redness of the part but a sensation of heat and prickling of palms,before attacks .The vesicles can coalesce and present as large bullae, especially on the feet. The eruptions tend to subside spontaneously within a few weeks, though scratching can make them worse. The symptoms are known to be worse during the summer months
There cab be secondary infection with pustule formation and lymphangitis complicating the symptoms in certain patients.
I cases of recurrent attacks, dystrophic changes in the nails can take place, with irregular transverse ridging and pitting thickening and discolouration.
Contact dermatitis needs to be ruled out, especially in cases where there are asymmetrical lesions with the help of a careful history and patch test
Repeated attacks of prompholyx may produce hyperkeratotic lesions that mimic psoriasis vulgaris.
Homoeopathic medicines.
Ars Alb, Graphites, Ant y,Calc carb, Baryta Carb, Petroleum, Sepia, Lycopodium, Thuja Croton tig, Belladonna', Apis Rhux tox, Cantharis.