International Academy of Cosmetic Dermatology
Dyshidrosis represents the combination of vesicle formation, itching, and excessive sweating (hyperhidrosis). Where there is normal sweating, the condition might be called dyshidrotic-like hand dermatitis or eczema.
The use of the term dyshidrostic relates to the concept that sweat glands or sweating might be involved in vesiculobullous hand dermatitis. Sweating is now considered to be an aggravating factor, rather than a causative one. Neither sweat glands nor sweat ducts show irregularities on the microscopic level.
Dyshidrotic hand dermatitis is quite common in occupations involving so-called wet work. Prevention often consists of reduction of exposure to the wetness by utilizing gloves. Smoking is known to aggravate the disease.
Symptomatic treatment includes applications of topical corticosteroids or topical calcineurin inhibitors. Sweating may be reduced with the use of tannins or aluminium salts or tap water iontophoresis. Unfortunately, this is a chronic condition that may wax and wane.
Uwe Wollina, MD