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December 2007

Acute and Recurrent Vesicular Hand Dermatitis Not Pompholyx or Dyshidrosis

Arch Dermatol. 2007;143(12):1578-1580. doi:10.1001/archderm.143.12.1578

In this issue, Guillet et al1 discuss the potential causes of pompholyx in 120 patients they studied during a 3-year period. For dermatologists interested in hand eczemas, this study highlights issues that can confound any hand eczema study.

For starters, we confront the matter of terminology. The authors cite the description of “dysidrosis” given by Tilbury Fox2 in 1873 as being related to “difficult sweating” and characterized by recurrent crops of vesicles or bullae (on nonerythematous skin) located on the lateral aspects of the fingers and on the palms and soles.2 Hutchinson,3 describing the same entity in 1876, added the term cheiro-pompholyx, or vesicular eruption of the hands, but discounted sweating. Ever since, the terms dyshidrosis and pompholyx have been used by authors and practitioners to describe the same condition, different conditions, or simply any chronic and often disabling vesicular hand eczema (despite the fact that episodic recurrences and absence of erythema are included in the classic definitions of both dyshidrosis or pompholyx).

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