Pompholyx (dyshidrosis) Eczema 汗疱疹
A 35-year-old woman came with a serious case of hand eczema, which she reported had begun approximately two years ago. She described experiencing intense itching and occasional burning sensations. Additionally, there were visible signs of fissures forming and the skin on her palms becoming hardened.
The patient explained that her dermatologist had previously prescribed several short tapering courses of systemic corticosteroids, which had proven highly effective in managing the blistering outbreaks. However, once she discontinued the steroid treatment, her eczema returned to a level similar to what it was before starting the treatment.
The dermatologist then proposed a PUVA treatment regimen, but the patient was hesitant due to the long distance required to reach the treatment center. Consequently, she decided to forgo any form of treatment for the past six months, resigning herself to endure her condition without intervention.
The patient sought out our clinic seeking an alternative herbal Traditional Chinese Medicine (TCM) approach to address her condition. On examination, it became apparent that nearly her entire hand area was afflicted with small, deeply-rooted pompholyx blisters.
Over the course of the subsequent 10 months, we tailored a personalized herbal compound and provided a topical herbal cream as treatment. She experienced remarkable symptom relief, with a 75% reduction in symptoms after 6 months, which progressed to complete clearance by the conclusion of her treatment regimen. Importantly, she did not experience any adverse effects from the treatment, and her laboratory values remained stable throughout the duration of her therapy.
Discussion
Pompholyx eczema is also referred to as ‘vesicular eczema of palms and soles.’ It was previously known as ‘dyshidrotic eczema,’ but this term has fallen out of use because no definitive link to sweat glands or sweating has been established. Pompholyx eczema is characterized as a vesiculobullous disorder affecting the hands and soles. It manifests as an intraepidermal spongiosis within the thick epidermis, where the accumulation of fluid leads to the formation of small, taut, clear vesicles primarily located on the sides of the fingers. These vesicles can grow in size, eventually developing into bullae. The diagnosis is primarily clinical and is indicated by the recurrent appearance of a rash with sudden onset, featuring vesicles and bullae that extend from the fingers to the palm surfaces of the hands.
Reference
Pompholyx: a review of clinical features, differential diagnosis, and management. Wollina U. Am J Clin Dermatol. 2010;11:305–314.
Privacy
In situations where the disease information had already been made publicly available (as evidenced by prior articles), genuine names of individuals have been utilized. Conversely, in instances where there was no pre-existing public disclosure or at the explicit request of patients for privacy, pseudonyms have been employed. Furthermore, identities have been deliberately obscured, and certain contextual details and diagnoses have been modified to hinder any attempts at identification. It is essential to emphasize that the patients and encounters described in this work are authentic, and their consent for publication was duly obtained. As responsible authors, we earnestly implore all our readers to honor the privacy and confidentiality of these individuals. Additionally, certain scenarios, assessments, and clinical interventions have been altered to safeguard the anonymity of both patients and healthcare providers.
