16th July 2026

Dyshidrotic eczema (Pompholyx)

Clinical features

Pompholyx is characterised by vesicles and can be as large as bullae, usually deep-seated on the palms and soles. It is often associated with intense itchiness and a burning sensation. Once the blisters healed, the skin can become red, dry and cracked. However, most of the time, the vesicles will gradually subside or resolve spontaneously. Up to 50% of patients will have a family or personal history of atopic dermatitis. Females are more commonly affected than males. Cause of the rash is unknown and thought to be aggravated by hot and humid weather, emotional stressors, exposure to irritants or allergens.

Investigations

• Usually diagnosed clinically
• Skin biopsy can be performed if diagnosis is uncertain
• Patch testing can be used if a component of allergic dermatitis is suspected

Management

• General measures include wet dressings to dry up blisters, such as diluted potassium permanganate, emollient, antiperspirant applied to palms and soles at night, and wear gloves if working with irritants or allergens 
• Topical steroids- Greater potency steroid is normally used, given thick skin on palms and soles 
• Antibiotics if infection present