What are the main symptoms of dyshidrotic eczema. How is dyshidrotic eczema diagnosed. What treatments are available for managing dyshidrotic eczema. Who is most at risk for developing dyshidrotic eczema. Can dyshidrotic eczema be prevented.

What is Dyshidrotic Eczema?

Dyshidrotic eczema, also known as dyshidrosis, pompholyx, or vesicular eczema, is a skin condition characterized by the sudden appearance of small, itchy blisters on the palms, sides of fingers, and soles of feet. This chronic condition tends to come and go over time, with no known cure. However, various treatments can help manage symptoms and reduce flare-ups.

Recognizing the Symptoms of Dyshidrotic Eczema

The hallmark of dyshidrotic eczema is the eruption of tiny, fluid-filled blisters. These blisters typically appear in clusters and can be accompanied by several other symptoms:

• Intense itching or burning sensation before blisters emerge
• Redness and cracking of the skin
• Excessive sweating around the affected areas
• Thickening and discoloration of nails
• Pain and difficulty using hands or walking if severely affected

Do the blisters of dyshidrotic eczema resolve on their own? Typically, these blisters subside within 2 to 3 weeks. However, the skin underneath may remain red and tender for some time afterward.

Unraveling the Causes of Dyshidrotic Eczema

While the exact cause of dyshidrotic eczema remains unclear, several factors have been identified as potential triggers:

1. Stress
2. Contact with metals (nickel, cobalt, chromium salts)
3. Excessive sweating
4. Humid weather conditions
5. Seasonal allergies
6. Weakened immune system

Is dyshidrotic eczema hereditary? While not directly inherited, having a family history of the condition or other forms of eczema can increase one’s risk. It’s important to note that dyshidrotic eczema is not contagious and cannot be transmitted through physical contact.

Diagnosing Dyshidrotic Eczema: What to Expect

Diagnosing dyshidrotic eczema primarily relies on a visual examination by a dermatologist. There is no specific lab test to confirm the condition. However, your doctor may recommend additional tests to rule out other skin conditions with similar symptoms.

Could patch tests be helpful in diagnosing dyshidrotic eczema? Yes, patch tests can be beneficial, especially if an allergy to metals like nickel is suspected. These tests involve applying small amounts of potential allergens to the skin to observe any reactions.

Steps in the Diagnostic Process

• Physical examination of hands, feet, and nails
• Review of medical history and symptoms
• Possible referral to an allergist for patch testing
• Differential diagnosis to exclude conditions like athlete’s foot

Effective Treatment Strategies for Dyshidrotic Eczema

While there’s no cure for dyshidrotic eczema, various treatment options can help manage symptoms and prevent flare-ups:

Topical Treatments

• Steroid ointments or creams to reduce inflammation
• Tacrolimus or pimecrolimus for immune system modulation
• Moisturizers to prevent dryness and cracking

Oral Medications

• Antihistamines to relieve itching
• Oral steroids for severe flare-ups

Advanced Therapies

• Light therapy using ultraviolet (UV) light
• Botulinum toxin injections to reduce sweating
• Draining of blisters by a dermatologist

How effective is light therapy for dyshidrotic eczema? Light therapy has shown promising results in many cases, especially when combined with a sensitizing medication to enhance the skin’s response to UV light.

Home Remedies and Lifestyle Changes for Managing Dyshidrotic Eczema

In addition to medical treatments, several home care strategies can help control symptoms and prevent flare-ups:

1. Gentle daily washing of hands and feet with lukewarm water and mild soap
2. Removing rings before washing hands to prevent moisture trapping
3. Wearing gloves with cotton liners for wet work
4. Applying thick moisturizer immediately after washing while skin is still damp
5. Using a humidifier in dry weather

Can dietary changes help manage dyshidrotic eczema? While there’s no specific diet for dyshidrotic eczema, some individuals find that avoiding certain foods, particularly those high in nickel, can help reduce flare-ups. However, it’s essential to consult with a healthcare provider before making significant dietary changes.

Understanding the Risk Factors and Complications of Dyshidrotic Eczema

Certain factors may increase the likelihood of developing dyshidrotic eczema:

• Age: Most common in adults between 20 and 40 years old
• Gender: Women are twice as likely to be affected
• Allergies: Having conditions like hay fever increases risk
• Other forms of eczema: About half of those with dyshidrotic eczema also have other types

What are the potential complications of untreated dyshidrotic eczema? If left untreated, dyshidrotic eczema can lead to several complications:

• Bacterial infections due to excessive scratching
• Chronic hand or foot eczema
• Nail changes or damage
• Impaired quality of life due to pain and functional limitations

Preventing Flare-ups and Long-term Management of Dyshidrotic Eczema

While it may not be possible to completely prevent dyshidrotic eczema, several strategies can help reduce the frequency and severity of flare-ups:

1. Identifying and avoiding triggers
2. Maintaining good hand and foot hygiene
3. Managing stress through relaxation techniques or therapy
4. Protecting hands and feet from excessive moisture and irritants
5. Regular use of prescribed treatments and moisturizers

Is dyshidrotic eczema a lifelong condition? While dyshidrotic eczema is typically chronic, some individuals may experience a decrease in symptoms as they age. Mild cases may even resolve on their own over time.

Long-term Outlook and Coping Strategies

Living with dyshidrotic eczema can be challenging, but with proper management, most people can effectively control their symptoms. Here are some tips for coping with the condition:

• Educate yourself about the condition and its triggers
• Adhere to your treatment plan consistently
• Communicate openly with your healthcare provider about your symptoms and concerns
• Join support groups or online communities for emotional support and practical advice
• Explore stress-reduction techniques like mindfulness or yoga

Can occupational changes help manage dyshidrotic eczema? For individuals whose work involves frequent hand washing or exposure to irritants, occupational changes or adaptations may be necessary. This could include using protective equipment, changing work processes, or in some cases, considering a change in occupation to reduce exposure to triggers.

Emerging Research and Future Directions in Dyshidrotic Eczema Treatment

As our understanding of dyshidrotic eczema continues to evolve, researchers are exploring new treatment options and management strategies:

Promising Areas of Research

• Biologics: Targeted therapies that modulate specific components of the immune system
• Microbiome studies: Investigating the role of skin bacteria in eczema development and treatment
• Gene therapy: Exploring genetic factors that may contribute to dyshidrotic eczema
• Novel topical treatments: Development of new non-steroidal anti-inflammatory agents

How might advances in personalized medicine impact dyshidrotic eczema treatment? The future of dyshidrotic eczema treatment may involve more personalized approaches, tailoring therapies based on an individual’s genetic profile, immune system characteristics, and specific triggers.

Ongoing Clinical Trials

Several clinical trials are underway to evaluate new treatments for dyshidrotic eczema. These include:

1. Testing of new biologics and small molecule drugs
2. Evaluation of combination therapies
3. Studies on the efficacy of probiotics and prebiotics
4. Investigation of novel delivery methods for existing medications

Individuals interested in participating in clinical trials should consult with their healthcare provider and visit reputable clinical trial registries for current opportunities.

The Impact of Dyshidrotic Eczema on Quality of Life

Dyshidrotic eczema can significantly affect an individual’s quality of life, impacting both physical and emotional well-being:

Physical Impact

• Difficulty performing daily tasks due to blisters on hands and feet
• Sleep disturbances caused by itching and discomfort
• Limitations in certain activities or sports
• Potential occupational challenges

Emotional and Psychological Impact

• Stress and anxiety related to managing the condition
• Self-consciousness about the appearance of affected skin
• Frustration with chronic nature of the condition
• Social withdrawal during severe flare-ups

How can individuals cope with the psychological impact of dyshidrotic eczema? Seeking support from mental health professionals, joining support groups, and practicing stress-reduction techniques can be beneficial. Additionally, open communication with friends, family, and colleagues about the condition can help alleviate social anxieties.

Strategies for Improving Quality of Life

1. Developing a consistent skincare routine
2. Exploring hobby adaptations during flare-ups
3. Using adaptive tools for daily tasks when hands are affected
4. Practicing self-compassion and patience during healing periods
5. Educating others about the condition to increase understanding and support

By implementing these strategies and working closely with healthcare providers, individuals with dyshidrotic eczema can effectively manage their symptoms and maintain a good quality of life.

Dyshidrotic Eczema: Symptoms, Causes, Diagnosis, Treatment

Written by Stephanie Watson

• What Is Dyshidrotic Eczema?
• Dyshidrotic Eczema Symptoms
• Dyshidrotic Eczema Causes
• Dyshidrotic Eczema Diagnosis
• Dyshidrotic Eczema Treatment

Dyshidrotic eczema is a sudden rash of small, itchy blisters on your palms and along the sides of your fingers. This skin condition can also make blisters pop up on the soles of your feet or on your toes.

Your doctor might call it by another name, including dyshidrosis, foot-and-hand eczema, pompholyx, vesicular eczema, or palmoplantar eczema.

There’s no cure, so these blisters will come and go over time. But you can manage them with medicine, moisturizers, and good hygiene. They might start to taper off once you get into middle age. And if you have a mild case, it could go away on its own.

The small, itchy blisters are the most noticeable sign of dyshidrotic eczema. These usually pop up in clusters. You may also have: 

• Itching or a burning pain before blisters appear 

• Blisters on the edges of your fingers, toes, palms, and soles of your feet

• Red, cracked skin

• Sweaty skin around the blisters 

• Nails that thicken and change colors

The blisters often go away in 2 to 3 weeks. But the skin underneath can be red and tender for a while.

Dyshidrotic eczema can be mild or severe. If you have a severe case that affects your feet, the blisters can make it hard to walk. Blisters on your hands can make it hard to do things like cook, type, or wash dishes.

Sometimes, the blisters can get infected, especially if you scratch them a lot. Signs that you have an infection include:

• Pain

• Swelling

• Crusting

• Pus in the blisters

Doctors aren’t sure what causes dyshidrotic eczema. It mostly affects adults ages 20 to 40, and it’s twice as common in women as in men. You’re more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema. 

Several things can set off dyshidrotic eczema, including:

• Stress

• Contact with metals like nickel, cobalt, or chromium salts on your job, or from things like costume jewelry

• Sweaty or wet hands and feet

• Warm, humid weather

• HIV infection

• Certain treatments for a weak immune system (immunoglobulin)

• Seasonal allergies

About half of all people with dyshidrotic eczema also have other types of eczema such as contact and atopic dermatitis. This condition isn’t contagious. You can’t catch it from touching someone who has it.

No lab test can confirm that you have dyshidrotic eczema, but if you notice blisters on your hands and feet, see a dermatologist (a doctor who specializes in your skin). They’ll look at your hands and feet, as well as your nails. Your doctor could also suggest tests to rule out other conditions with similar symptoms like athlete’s foot.

You also might need to see an allergy doctor (allergist). Patch tests can show if you have an allergy to nickel or another metal. During these tests, your doctor will put patches with a small amount of different metals or other things on your skin to see whether you react to them.

Your doctor can prescribe an ointment or cream with a steroid in it to bring down swelling and help get rid of the blisters. Your skin will take in the medicine better if you put a wet compress on it after you use the cream. If you have a severe flare-up, you might need to take a steroid drug, like prednisone, in a pill.

An antihistamine like diphenhydramine (Benadryl) or loratadine (Alavert, Claritin) can help with the itch, too. Or you might hold a cold, wet compress on the blisters for 15 minutes at a time several times a day.

If these treatments don’t work well for you, you might try one of these:

• Light therapy. This uses ultraviolet (UV) light to clear up your skin. You might first get a sensitizing medication to help your skin respond better to the light.

• Botulinum toxin. These shots stop your hands and feet from sweating, which can trigger the blisters.

• Medicines that slow your immune system. Tacrolimus (Protopic) ointment or pimecrolimus (Elidel) cream can calm the swelling and irritation. These drugs can be options if you don’t want to take steroids.

• Draining the blisters. Your dermatologist can drain fluid from the blisters. Don’t try to do this yourself. You could make the eczema worse.

To control the blisters at home:

• Wash your hands and feet every day. Use lukewarm water and a mild, scent-free soap. Afterward, gently pat your skin dry.

• Take your rings off before you wash your hands. Moisture can get trapped under your rings and cause more blisters.

• Wear gloves with cotton liners whenever your hands are in water, like when you wash dishes.

• Put a thick moisturizer on your hands and feet every time you shower or wash. Rub it on while your skin is still wet to seal in water. You also might use a cream that has dimethicone to protect your skin.

• Turn on a humidifier in dry weather to keep your skin from cracking.

• If allergies set off your eczema, try to stay away from things that trigger them.

• Don’t scratch the blisters. You’ll make them worse.

If you’re sensitive to nickel or cobalt, your dermatologist might tell you not to eat foods that are high in these metals. Nickel is in foods like chocolate, broccoli, legumes, and nuts. Cobalt is in shellfish, liver, nuts, beets, cabbage, and chocolate.

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Dyshidrotic Eczema: Symptoms, Causes, Diagnosis, Treatment

Written by Stephanie Watson

• What Is Dyshidrotic Eczema?
• Dyshidrotic Eczema Symptoms
• Dyshidrotic Eczema Causes
• Dyshidrotic Eczema Diagnosis
• Dyshidrotic Eczema Treatment

Dyshidrotic eczema is a sudden rash of small, itchy blisters on your palms and along the sides of your fingers. This skin condition can also make blisters pop up on the soles of your feet or on your toes.

Your doctor might call it by another name, including dyshidrosis, foot-and-hand eczema, pompholyx, vesicular eczema, or palmoplantar eczema.

There’s no cure, so these blisters will come and go over time. But you can manage them with medicine, moisturizers, and good hygiene. They might start to taper off once you get into middle age. And if you have a mild case, it could go away on its own.

The small, itchy blisters are the most noticeable sign of dyshidrotic eczema. These usually pop up in clusters. You may also have: 

• Itching or a burning pain before blisters appear 

• Blisters on the edges of your fingers, toes, palms, and soles of your feet

• Red, cracked skin

• Sweaty skin around the blisters 

• Nails that thicken and change colors

The blisters often go away in 2 to 3 weeks. But the skin underneath can be red and tender for a while.

Dyshidrotic eczema can be mild or severe. If you have a severe case that affects your feet, the blisters can make it hard to walk. Blisters on your hands can make it hard to do things like cook, type, or wash dishes.

Sometimes, the blisters can get infected, especially if you scratch them a lot. Signs that you have an infection include:

• Pain

• Swelling

• Crusting

• Pus in the blisters

Doctors aren’t sure what causes dyshidrotic eczema. It mostly affects adults ages 20 to 40, and it’s twice as common in women as in men. You’re more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema. 

Several things can set off dyshidrotic eczema, including:

• Stress

• Contact with metals like nickel, cobalt, or chromium salts on your job, or from things like costume jewelry

• Sweaty or wet hands and feet

• Warm, humid weather

• HIV infection

• Certain treatments for a weak immune system (immunoglobulin)

• Seasonal allergies

About half of all people with dyshidrotic eczema also have other types of eczema such as contact and atopic dermatitis. This condition isn’t contagious. You can’t catch it from touching someone who has it.

No lab test can confirm that you have dyshidrotic eczema, but if you notice blisters on your hands and feet, see a dermatologist (a doctor who specializes in your skin). They’ll look at your hands and feet, as well as your nails. Your doctor could also suggest tests to rule out other conditions with similar symptoms like athlete’s foot.

You also might need to see an allergy doctor (allergist). Patch tests can show if you have an allergy to nickel or another metal. During these tests, your doctor will put patches with a small amount of different metals or other things on your skin to see whether you react to them.

Your doctor can prescribe an ointment or cream with a steroid in it to bring down swelling and help get rid of the blisters. Your skin will take in the medicine better if you put a wet compress on it after you use the cream. If you have a severe flare-up, you might need to take a steroid drug, like prednisone, in a pill.

An antihistamine like diphenhydramine (Benadryl) or loratadine (Alavert, Claritin) can help with the itch, too. Or you might hold a cold, wet compress on the blisters for 15 minutes at a time several times a day.

If these treatments don’t work well for you, you might try one of these:

• Light therapy. This uses ultraviolet (UV) light to clear up your skin. You might first get a sensitizing medication to help your skin respond better to the light.

• Botulinum toxin. These shots stop your hands and feet from sweating, which can trigger the blisters.

• Medicines that slow your immune system. Tacrolimus (Protopic) ointment or pimecrolimus (Elidel) cream can calm the swelling and irritation. These drugs can be options if you don’t want to take steroids.

• Draining the blisters. Your dermatologist can drain fluid from the blisters. Don’t try to do this yourself. You could make the eczema worse.

To control the blisters at home:

• Wash your hands and feet every day. Use lukewarm water and a mild, scent-free soap. Afterward, gently pat your skin dry.

• Take your rings off before you wash your hands. Moisture can get trapped under your rings and cause more blisters.

• Wear gloves with cotton liners whenever your hands are in water, like when you wash dishes.

• Put a thick moisturizer on your hands and feet every time you shower or wash. Rub it on while your skin is still wet to seal in water. You also might use a cream that has dimethicone to protect your skin.

• Turn on a humidifier in dry weather to keep your skin from cracking.

• If allergies set off your eczema, try to stay away from things that trigger them.

• Don’t scratch the blisters. You’ll make them worse.

If you’re sensitive to nickel or cobalt, your dermatologist might tell you not to eat foods that are high in these metals. Nickel is in foods like chocolate, broccoli, legumes, and nuts. Cobalt is in shellfish, liver, nuts, beets, cabbage, and chocolate.

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Rubella in children and adults: symptoms, methods of treatment

Author

Zurnadzhi Elena Vyacheslavovna

Leading physician

Pediatrician

Creation date: 2016. 03.30

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Rubella

Rubella is an acute viral disease predominantly of childhood. A typical manifestation: a pink-red rash that appears first on the face, and then spreads throughout the body within a few hours.

The susceptibility of children to rubella is high. Usually, children under the age of 6 months have innate immunity received from their mother, but if the child does not have specific antibodies, he can get sick even in the first months of life.

Rubella is most common in children aged 2 to 9 years.

Immunity after the transferred rubella is persistent, lifelong.

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Causes of rubella

Rubella is transmitted by airborne droplets. Although the virus is considered non-persistent, contact transmission of the disease (for example, through children’s toys) is also possible.

The incubation period for rubella is from 11 to 24 days (in most cases – from 16 to 20 days). The patient is contagious already a week before the rash appears. After the rash, the risk of infection persists for another 5-7 days.

Another option for transmission of infection is during pregnancy, from mother to fetus. With such congenital rubella, the virus is secreted for a long time – within 1.5-2 years after birth (with sputum, urine, feces).

Rubella risk

The main danger of the disease lies in its effect on the fetus in the early stages of pregnancy. Up to 11 weeks, the probability of infection of the fetus upon contact with the source of infection is 90%. The consequences can be serious: various pathologies and fetal death. Therefore, rubella is included in the number of ToRCH infections (a group of infections that pose a particular danger to the fetus and the health of the unborn child).

Symptoms of rubella

The main symptoms of rubella are:

Rash

Rubella is manifested primarily by a rash. The rubella rash looks like small pink-red spots of a round or oval shape.

In children, the rash lasts 2-4, occasionally 5-7 days, then disappears – without pigmentation and peeling.

More about the symptom

Swollen lymph nodes

There is enlargement of the lymph nodes, especially those located on the back of the head and back of the neck.

Catarrhal phenomena

Sometimes in children with rubella, catarrhal phenomena are observed: a slight runny nose, sore throat, dry cough.

Symptoms of rubella in adults

In adults, rubella is much more severe: headache, general weakness, fever (up to 38-39 ° C), muscles hurt. The disease can affect the joints (primarily the small joints of the hands).

Methods for diagnosing rubella

Do not assume that you or your child is already immune because you have experienced symptoms that fit the description of rubella. Other viral diseases can have similar symptoms. Absolute certainty can only be given by a blood test for specific antibodies.

Serological blood test

Serological analysis detects the presence of antibodies to the rubella virus in the blood. Such an analysis can be done separately, or you can use the “Diagnostics of ToRCH infections” profile.

More about the diagnostic method

To accurately diagnose the disease, make an appointment with the specialists of the Family Doctor network.

Rubella treatments

If symptoms appear that suggest rubella, the child should be shown to the pediatrician, and the adult should consult a general practitioner.

Symptomatic treatment

Rubella is treated with bed rest and symptomatic treatment. The patient should receive enough vitamins (in the form of vitamin preparations or in kind).

Vaccination

Vaccination is a simple and effective way to avoid the danger of getting sick already in adulthood. It is especially important to exclude the threat of rubella disease to the expectant mother. The prevention of this disease is so significant that rubella vaccination is included in the National and Regional immunization schedules.

The vaccine is administered subcutaneously or intramuscularly. Vaccination is carried out at the age of 12 months, repeated immunization (revaccination) – at 6 years. For girls who have not had rubella and have not previously been vaccinated, the vaccine is administered at the age of 18 to 25 years. Specific immunity is provided in almost 100% of cases. It develops 15-20 days after vaccination and persists for more than 20 years.

More about the treatment

Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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Dyshidrotic eczema – Eva Art

Why do itchy blisters appear on the palms and feet?

Dyshidrotic eczema is a type of eczema (dermatitis) that is characterized by an itchy, blistering rash on the fingers, hands and feet. It occurs in children and adults and can be acute, recurrent, or chronic. In English-language literature, the term “pompholyx” is used for this condition, which means “bubble”. The clinical course of dyshidrotic eczema can vary from mild, self-limiting to severe, chronic, and debilitating, resistant to treatment. It is impossible to single out an unambiguous cause of dyshidrotic eczema. It is believed that pompholyx is a skin reaction caused by various external and internal provoking factors.

The most likely causes of dyshidrotic eczema are as follows:

1. Genetic factors. Filaggrin is a structural protein in the stratum corneum of the skin that plays an important role in its barrier function. Mutations in the filaggrin gene cause disruption of the skin barrier. This leads to increased permeability of allergens into the skin.
2. Atopy. According to some reports, about half of patients with dyshidrotic eczema have a personal or family history of atopy (atopic dermatitis, asthma, allergic rhinitis). Serum immunoglobulin E (IgE) levels are often elevated even in patients reporting no history of atopy.
3. Hypersensitivity (allergy) to nickel. Nickel contact dermatitis has been reported in 30% of patients with dyshidrotic eczema. Nickel ingestion with food can also be a cause of dyshidrotic eczema in some patients. Increased urinary nickel excretion has been reported during exacerbations of pompholyx.
Profuse sweating is thought to result in localized concentrations of metal salts that can induce a blistering reaction.
A diet low in nickel may reduce the frequency and severity of pompholyx flare-ups.
4. Hypersensitivity to cobalt. When cobalt is consumed with food, allergic dermatitis in the form of dyshidrotic eczema occurs less frequently than when nickel is taken orally. Much more common is the co-occurrence of nickel and cobalt allergy, seen in 25% of nickel-sensitive patients who develop pompholyx. In these cases, the eczema is usually more severe.
A low cobalt diet has been suggested to help patients limit their intake and keep blood levels of cobalt below the threshold for pompholyx flare-ups. In addition, this diet reduces the amount of nickel consumed.
5. Contact exposure to allergenic chemicals or metals. Dyshidrotic eczema flare-ups are sometimes associated with exposure to allergenic chemicals found in metals or cosmetics (eg, chromium, fragrances, dyes, preservatives, etc.)
Shower gel, shampoo, hair dye, etc. often act as a contact allergen.
6. Fungal infection. In some patients, pompholyx develops with a fungal infection and resolves with antifungal treatment.
7. ID reaction. This is a reaction to distant foci of a fungal or bacterial infection. For example, with a fungal infection of the feet (or bacterial interdigital diaper rash), itchy blisters may appear on the hands.
8. Emotional stress. This is a possible factor in dyshidrotic eczema. Many patients report recurrences of pompholyx during stressful periods.
9. Hyperhidrosis – excessive sweating. To date, it has been proven that hyperhidrosis of the palms and feet is not the cause of pompholyx, but is an aggravating factor in 40% of patients with dyshidrotic eczema. Reducing sweating of the palms after the introduction of botulinum toxin helps to reduce / stop itching and blisters.
10. Climatic and seasonal factors. Environmental factors (seasonal increase in temperature, high humidity) exacerbate rashes in the form of bubbles.
Although phototherapy is a known effective treatment for pompholyx, exposure to ultraviolet A rays can trigger an outbreak in some patients. The use of photoprotective agents in this case leads to a decrease in the frequency and severity of exacerbations.
11. Other factors. The results of various studies describe other possible causes of the development of pompholyx, such as taking certain drugs, foods, smoking tobacco, diseases of the internal organs.