Dyshidrosis is a skin condition that is characterized by small blisters on the hands or feet -- apparently related to stress. The tips and sides of the fingers, toes, palms, and soles are involved.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Psychotherapy or counseling to help your child learn to cope with stress more effectively.
SIGNS & SYMPTOMSBlisters are very small (1mm or less in diameter). They appear on the tips and sides of the child's fingers, toes, palms, and soles.
Blisters are opaque and deep-seated; they are either flush with the child's skin or slightly elevated. They don't break easily. Eventually, small blisters come together and form large blisters.
Blisters may itch, cause pain, or produce no symptoms in your child. They worsen after contact with soap, water, or irritating substances.
Small blisters with the following characteristics:
CAUSESUnknown, but they are probably related to periods of anxiety, stress, and frustration in children who internalize their emotions. Children with dyshidrosis have difficulty relaxing--even during non-stressful periods.
This problem is not caused by sweat retention, as was once believed.
RISK FACTORSStress and internalized frustration or irritation.
PREVENTING COMPLICATIONS OR RECURRENCEFollow instructions under HOME CARE. These are helpful in preventing recurrences, as well as in treating active episodes.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
POSSIBLE COMPLICATIONSSecondary bacterial infection (sometimes).
Your child's symptoms can be controlled with treatment, but recurrence is common. Children with mild dyshidrosis have occasional attacks, and the skin returns to normal between episodes. Children with severe dyshidrosis have more severe symptoms -- sometimes with persistent peeling and fissuring of the involved skin.
HOME CAREInstructions for your child to keep heat and moisture away from the affected areas:
Wear cotton socks and leather-soled shoes. Don't wear tennis shoes or other footwear made of man-made materials.
Remove shoes and socks frequently to allow sweat to evaporate.
Wear heavy-duty vinyl gloves to prevent contact with irritating substances, such as water, soap, detergent, metal scrubbing pads, scouring powder, and other chemicals.
Dry insides of gloves after use. Discard a glove if it develops a hole.
Wear gloves when you peel or squeeze acid fruits and vegetables.
Wear leather or heavy-duty fabric gloves for household chores or gardening.
Use a dishwashing machine to wash dishes if possible. If not, ask someone else to wash them.
Avoid contact with irritating chemicals, such as paint and paint thinner and polish for cars, floors, shoes, furniture, and metal.
Remove rings before doing housework or washing hands.
Use lukewarm water and very little mild soap to shower or bathe.
MEDICATIONUse non-prescription topical steroid preparations to reduce inflammation and decrease the child's itching. Apply once or twice a day to the child after bathing, unless directed otherwise. If these are not effective, your doctor may prescribe stronger steroid preparations.
See Medications section for information regarding medicines your doctor may prescribe.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes. This condition is not contagious to others.
CALL YOUR DOCTOR IF
Your child has symptoms of dyshidrosis.
Signs of infection (swelling, redness, tenderness, or warmth) appear around blisters.
Symptoms don't improve after a week, despite treatment.
Improvement begins, and then symptoms recur.