Causes and when to speak with a doctor

Hand rashes can result from allergic reactions, exposure to irritants, and sunburn. Health conditions, such as psoriasis and eczema, can also cause hand rashes. Treatment will depend on the cause.

In this article, we look at the possible causes of a rash on a person’s hands and when to seek medical help.

Below are images of different rashes on the hands from a variety of causes.

Contact dermatitis is a condition that causes changes in skin color, itching, and irritation. Irritant contact dermatitis results from direct exposure to substances and accounts for around 80% of dermatitis cases.

These substances directly affect the skin and may cause rashes on the hands if this is the site of exposure.

Common skin irritants include:

• hand soaps
• rubber or latex gloves
• nickel and gold jewelry
• citrus and other natural acids

Contact dermatitis usually goes away once people remove the irritant.

Discover some triggers of contact dermatitis in this article.

Several substances can cause minor allergic reactions on the skin. These substances may affect the hands when a person is gardening, using a new lotion, or having exposure to a chemical with which they have an allergy.

In allergic contact dermatitis, the immune system overreacts following contact with these substances, causing a rash, swelling, and irritation. This differs from irritant contact dermatitis, where the substances themselves cause symptoms.

It is possible to treat many minor allergic reactions at home. Learn how here.

Anaphylaxis is a severe and potentially life threatening allergic reaction that causes the body’s immune system to react aggressively to a substance. It sometimes begins with a slightly swollen rash similar to hives.

If the rash spreads quickly, it can lead to more severe symptoms, such as a swollen throat and trouble breathing.

A person who suddenly develops a rash following a sting, new medication, or exposure to another new substance should immediately contact a healthcare professional.

Anaphylaxis is a life threatening condition. Learn more here.

Hives often appear as raised, dumpy rashes. The bumps are itchy and may appear lighter when someone presses on them. The condition can result from irritant and allergen exposure, underlying health conditions, and other physical triggers.

Hives can be acute or chronic, and nearly 20% of people will experience the condition at some time in their lives. The medical term for hives is urticaria.

Find out what causes hives and how to treat them.

Eczema, sometimes called atopic dermatitis, is a chronic skin condition. It causes scaly patches on the skin that may be darker or lighter than the rest of the skin. The patches may be all over the body or just in one place, such as the hands.

The rash often itches and may worsen when the skin is dry or during cold or dry weather. Eczema is more common in children than in adults. After childhood, eczema typically goes away by itself, but many individuals can have the condition in adulthood.

There is a variety of eczema types. Learn more here.

Psoriasis is an autoimmune disease that causes an overgrowth of skin cells. This can cause rashes, inflammation, and raised, scaly, patches of skin known as plaques. The condition can occur in any part of the body.

Psoriasis tends to appear pink or red on those with light or fair skin tones, with scales appearing silvery-white. On medium skin tones, it can appear salmon-colored and feature silvery-white scales. On darker skin tones, psoriasis could look violet with gray scales or appear dark brown and difficult to see.

Psoriasis on the hands may also affect the nails. People with the condition on their hands may develop the rash elsewhere, such as on the scalp.

There is no cure for psoriasis, but some medications can help manage the condition.

More information on psoriasis is available here.

Exposure to sunlight can cause sunburn on any part of the body. Clothing rarely covers the hands, so it is important that people remember to apply sun cream to the back of their hands, fingers, and wrists when applying to the rest of the body.

Sunburn may hurt at first and then begin itching. The skin may look dry, blister, or peel. Sunburn can affect all people, although those with lighter skin have a higher risk of burning.

Find out how sunburn affects dark skin here.

Several genetic conditions can cause the skin on their hands to peel continuously. This peeling will often be painless, but it may result in swelling, skin discoloration, and localized discomfort.

The peeling may worsen during the summer or after frequent handwashing or exposure to water.

Learn more about peeling skin here.

Tinea manuum is a type of fungal infection of the hands, similar to athlete’s foot. It usually causes a rash with a raised border.

A person may contract the infection from a person, animal, or soil with tinea manuum or from touching the feet of someone with athlete’s foot. The rash is usually very itchy and can cause the nails to discolor or look misshapen.

More information about tinea manuum is available here.

Lichen planus is a common inflammatory skin condition. It causes swelling, discoloration of the skin, and bumps. It can affect any part of the body, including the mouth and scalp, but some people first notice the rash on their wrists or hands.

Find out all there is to know about lichen planus here.

Cellulitis is a bacterial infection of the skin’s deeper layers. If bacteria enter the skin, it can cause cellulitis.

A range of diseases or injuries can allow bacteria to penetrate the skin. A person can get cellulitis even after minor injuries, such as a cut from a razor or a bee sting.

Cellulitis may resemble a rash because it looks swollen and discolored, but it is a dangerous infection that can spread quickly.

Find out more about cellulitis here.

Treatment depends on the cause of the rash. It is usually safe to treat minor conditions, such as contact dermatitis and eczema, at home. The most common treatments include:

• steroid creams
• calamine lotion
• colloidal oatmeal
• moisturizers
• reducing sun exposure in cases of sunburn
• antifungal creams for fungal infections.

It is not possible to prevent all rashes. However, below are some strategies that may help:

• Use fragrance-free moisturizers to reduce the risk of irritation and allergic reactions.
• If a person has eczema, use a formulated cream, especially after washing hands.
• Wear gloves when working in the yard or using irritating chemicals.
• Avoid using medications, including medicated creams, unless necessary. This can reduce the risk of a medication-induced allergic reaction.

People should consult a doctor regarding any rash that does not go away on its own with home treatment. They should also seek medical attention if a rash starts spreading.

A person should call a healthcare professional immediately if:

• they have a fever and rash, or the rash shows signs of infection such as pus or oozing
• the rash is painful but not itchy
• the skin is very swollen
• they have other symptoms, such as symptoms of a cold or the flu
• a rash appears all over the body, especially after an insect sting or taking medication
• a person has a rash and has trouble breathing

Various substances, conditions, and infections can cause rashes on the hands.

Most rashes are not serious and will go away independently, even without treatment. If a rash hurts, appears suddenly, or does not go away, it may indicate a more serious problem.

Prompt medical treatment may ease the pain and treat the rash.

Palm rash: Causes, pictures, and treatments

Palm rashes can occur due to common skin conditions, such as eczema, or due to irritants and allergens. Most cases are not severe, and depending on the cause, the rash may improve on its own.

This article explores common causes for a rash on the palms, along with their symptoms and treatments.

A rash on the palms of the hands will look and feel differently depending on what causes it.

Most rashes look inflamed and may cause pain or itchiness. In paler skin, they may be red, while in darker skin, they may be grey, violet, or dark brown. Some rashes can also cause blistering, peeling, or flaking.

A palm rash might cause discomfort when closing the hand into a ball, or cause irritation when a person touches certain substances. Frequently washing the hands may dry the skin further.

[Slideshow]

Some possible triggers of palm rashes include:

Eczema

Eczema, or atopic dermatitis, is a common condition that causes dry, sensitive skin. It typically affects young children but may continue into adulthood.

Symptoms include:

• itching
• dry skin that may crack
• red patches in lighter skin, and grey or purple areas in darker skin

Some forms of the condition are more common on the palms, such as dyshidrotic eczema. This type of eczema can cause small blisters on the hands, fingers, and palms.

Eczema treatments vary depending on the severity of the condition. There are many over-the-counter (OTC) moisturizers for mild to moderate cases. More severe cases may require corticosteroids or antihistamines.

Learn more about the causes and treatments for atopic dermatitis.

Contact dermatitis

Contact dermatitis is a skin condition that develops when the skin comes into contact with an irritant or allergen. Many different substances can trigger contact dermatitis, including:

• nickel
• latex
• poison ivy

When the skin comes into contact with something the body perceives as dangerous, this can cause a rash. This rash may:

• burn
• blister
• itch
• hurt

The skin may also become dry, and in severe cases, crack. Because the hands touch many different substances each day, they are a common place where contact dermatitis can develop.

The main treatment is to identify and avoid the triggers for this condition. A doctor can perform a patch test on someone to determine what substance is causing the reaction. Some people may also benefit from moisturizers or corticosteroids.

Hives

Hives are raised red or skin-colored welts on the skin. They itch and can appear anywhere on the body, including the palms of the hands.

An allergic reaction to certain substances triggers this condition. These substances include foods, medications, or pollen. However, they can also occur in response to an infection or physical stimuli, such as heat or sun exposure.

Most cases of hives are acute and go away when there is no more exposure to the trigger causing the reaction. Antihistamines can also help reduce swelling and allergy symptoms.

However, some people have chronic hives. An allergy specialist can help someone manage this and, if possible, identify the cause.

Hand, foot, and mouth disease

A virus causes hand, foot, and mouth disease (HFMD). It most commonly affects children under 5 years old, but can also affect adults.

The symptoms of HFMD include:

• fever
• sore throat
• a rash on the hands and feet, consisting of painful blisters
• headache
• ulcers in the mouth
• loss of appetite

People sometimes confuse HFMD with foot and mouth disease. However, these are separate conditions. Foot and mouth disease can only affect livestock and does not affect humans.

Usually, HFMD is not serious and resolves without treatment in 7–10 days. In the meantime, OTC pain medication can help relieve symptoms.

However, HFMD is contagious and spreads easily. People can help prevent spreading the virus by practicing hand hygiene and avoiding close contact with others.

Fungal infection

Tinea manuum is a type of fungal infection that affects the hands. Ringworm triggers this condition, the same fungus that causes athlete’s foot. This condition is contagious, so touching other areas of the body affected with ringworm could lead to an infection on the palms.

Symptoms include:

• a small rash on the hands that gradually gets bigger
• itching
• skin that peels, flakes, or is scaly

A person can treat ringworm with OTC topical creams. A pharmacist can recommend an antifungal product for use on the hands. If the infection persists or is severe, a doctor may prescribe oral medication.

If a person has tinea manuum, they should avoid touching other areas of the body, or other people, as this can spread the infection. If people need to apply topical treatments to other parts of the body, they should wear disposable gloves.

Palmoplantar psoriasis

Palmoplantar psoriasis is an inflammatory condition that causes red, scaly patches to appear on the palms of the hands and soles of the feet. It is an autoimmune condition that occurs when the skin grows new cells too quickly.

Symptoms of psoriasis include:

• red, scaly patches of skin
• itching
• pain
• cracked skin that may bleed

Psoriasis can also affect the fingernails and toenails and may include pustules.

There is no cure for psoriasis, but there are treatments that can help someone manage it, including:

• moisturizers
• steroid creams
• UV light therapy
• medications to suppress the immune system, such as ciclosporin

Learn more about the symptoms and treatments for psoriasis.

To diagnose rashes on the palms, a doctor will look at the rash to assess its appearance. They may ask if the person has had any other symptoms, such as a fever or pain. They may also take a medical history or ask questions about skin conditions that run in someone’s family.

If a person could have contact dermatitis or hives, a doctor may recommend a skin prick test to determine the triggers.

There are ways to care for a palm rash at home. However, the techniques depend on the underlying cause.

For example, for fungal infections, a person may need to avoid touching the rash or sharing personal items with other people. OTC antifungal creams will help treat the disease.

For allergic reactions, people may need to make changes to their home environment, diet, or lifestyle to avoid triggers.

For dry skin, eczema, and contact dermatitis, there are several home remedies, including:

• taking warm showers or baths, ensuring they are not hot
• using gentle, nonirritating cleansers
• regularly applying a barrier cream, such as E45 or Eucerin
• moisturizing after bathing, showering, or washing the hands
• wearing cotton gloves at night to prevent scratching

Learn more about how to care for dry skin on the hands.

A person may wish to see a doctor so they can identify the cause of a palm rash. A medical professional can help identify the trigger and recommend treatments.

People should also see a doctor if they have ringworm that does not respond to OTC treatments, or their rash shows signs of a bacterial infection. The symptoms of a bacterial infection on the skin include:

• pus
• swelling
• feeling warm to the touch
• fever

People with hives or allergies should contact an emergency department or dial 911 immediately if they have trouble breathing.

Several conditions can trigger a palm rash. Most are not serious and may resolve on their own, or improve with OTC treatments and home care.

If a person has persistent or severe symptoms, or other symptoms accompanying the rash, they should speak to a doctor.

What is dyshidrosis and what to do about it?

Skin dyshidrosis is a disease in which small, fluid-filled blisters appear on the palms of the hands and fingers, as well as on the sides of the feet. The condition is twice as likely to affect women. It is also called dyshidrotic eczema.

Due to seasonal allergies, itchy blisters most often appear in the spring. They can disturb up to three weeks, and then they begin to dry out. Sometimes the blisters increase in size and become very painful. When they dry out, cracks in the skin can form in their place. After them, the skin can become rough and porous, especially if a person often scratched it.

Most often, blisters form on the palms and sides of the fingers. Feet are not always affected, but some people get blisters on them. Usually the bubbles are small – about the diameter of a pencil core.

In more severe cases, the blisters coalesce and form large blisters. The skin in areas with dyshidrosis can be very itchy and sore. After the blisters dry and flake off, which occurs after about 3 weeks, the underlying skin becomes red and tender.

The exact cause of this disease is not yet known. It has been associated with a similar skin disorder, atopic dermatitis, and also with allergic pollen. Dyshidrosis is often diagnosed in people with allergic rhinitis during allergy season.

Risk factors include:

• Age. This disorder can affect anyone, but most often affects adults between the ages of 20 and 40.
• Genetic predisposition. If someone close to you had skin dyshidrosis, your chances of encountering this disorder increase.
• Stress. Very often this condition manifests itself during a period of emotional stress or strong physical exertion.
• Nickel contact. It can be found in jewelry, keys, eyeglass frames, buttons, buttons, stainless steel items.
• Contact with cobalt. This metal is found in paints and varnishes, some medical equipment, jewelry, metal buttons, fasteners, and zippers.
• Contact with chromium salts. They are used in the production of cement, leather, paints and anti-corrosion agents.
• Skin sensitivity. Some people with sensitive skin develop dyshidrotic eczema after contact with some kind of irritant (not necessarily the aforementioned metals).
• The presence of atopic dermatitis in a person. Some people with this disorder may develop blisters.

For most people, skin dyshidrosis is a problem purely in terms of discomfort. Severe itching does not please anyone. For others, severe pain and itching prevent them from performing daily tasks or work. Constant or intense scratching can lead to a bacterial infection.

In most cases, the diagnosis of this condition is based on a physical examination of the patient by a dermatologist. There are no specific diagnostic procedures for this disease. But sometimes doctors prescribe tests to rule out skin conditions with similar symptoms.

For example, there is a condition called athletic foot. It is characterized by damage to the skin of the foot by a separate type of fungal infection. To diagnose it, a skin scraping of the foot is performed, and then a piece of biomaterial is sent to the laboratory, where it is studied under a microscope. Skin allergies or hypersensitivity to individual substances are determined by exposure of the skin to various substances. To do this, irritants are applied to the skin, and then sealed with a special plaster. After a certain period of time, the patch is removed, and the desired area of ​​\u200b\u200bthe skin is examined for inflammation or irritation.

How to treat dyshidrosis?

Unfortunately, this disorder cannot be cured at the moment. But we can control him and contain his outbursts. Depending on the severity of symptoms, doctors prescribe the following drugs:

• Corticosteroids . Powerful corticosteroid creams and ointments help speed up the process of the blisters disappearing. Wrapping the affected area with plastic wrap will improve the absorption of the ointment or cream. In the most severe cases, doctors prescribe oral corticosteroids such as prednisone. It is important to understand that long-term use of oral steroid medications can cause serious side effects. Among them are osteoporosis, hypertension, diabetes mellitus, cataracts, glaucoma and other diseases.
• Phototherapy . If other treatments for dyshidrosis have failed, doctors may prescribe a special type of light therapy. It combines exposure to ultraviolet rays with taking a drug that helps make the skin more receptive to ultraviolet light.
• Ointments that suppress the immune system . The drugs tacrolimus (Protopic) and pimecrolimus (Elidel) may be useful for people who want to limit the negative effects of steroids on the body. But these drugs also have a side effect – an increased risk of developing skin infections.
• Botulinum toxin injections . Some doctors may recommend botulinum toxin injections to treat severe dyshidrotic eczema.

How can I help myself?

To combat this disorder, it is recommended:

• Apply wet and cool compresses to help relieve itching.
• Take anti-itch medication. Over-the-counter antihistamines such as diphenhydramine or loratadine can relieve itching. But their reception must be agreed with the attending physician.
• Use moisturizing creams regularly.
• Use only mild detergents.
• Wash hands with mild soap and lukewarm water and dry thoroughly.

The best treatment for dyshidrotic eczema is its prevention. But all we can do is resist stress with all our might, and avoid irritants as much as possible, such as nickel, cobalt, chromium salts. Before buying rings, chains, metal household items and other items that may contain them, you need to make sure that the composition does not contain these metals.

Nickel and cobalt are also found in certain foods. Nickel can be found in:

• Cocoa and chocolate,
• Soybeans, fresh and dried legumes,
• Oatmeal,
• Nuts,
• Canned foods.

Cobalt can be found in:

• Fish and shellfish (including oysters),
• Green leafy vegetables,
• Liver,
• Milk,
• Nuts,
• Red meat (pork, beef, veal, lamb, sausages).

In order to determine the allergy to any food, you can take a blood test for antibodies to food allergens. But in order not to engage in self-appointment, it is better to immediately go for a consultation with a dermatologist. If you live in Kyiv, and especially on the Left Bank, come to our medical center.

Sources:

1. Dyshidrosis, Mayo Clinic,
2. Dyshidrotic Eczema, National Eczema Association.

dermatologist

skin diseases

skin diseases

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, palms, 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 proposed to help patients limit their intake and keep their blood cobalt levels below the threshold for developing 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 as a result of 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) aggravate 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 pompholyx development, such as the use of certain drugs, foods, tobacco smoking, diseases of the internal organs.
Given the variety of causes of dyshidrotic eczema, a detailed history and elimination of provoking factors play an important role in the treatment and prevention of this disease.

To prevent pompholyx recurrence, even in the absence of a rash, avoid skin irritants and use a moisturizer regularly to restore the skin barrier.