Pompholyx (Synonyms: Dysidrosis; Cheiro-pompholyx)
What is pompholyx?
Pompholyx is a rare disease of the skin of a vesicular and bullous character, and limited to the hands and feet.
Describe the symptoms of pompholyx.
In most instances the hands only are affected. It begins usually with a feeling of burning, tingling or tenderness of the parts, followed rapidly by the appearance of deeply-seated vesicles, especially between the fingers and on the palmar aspect. These beginning lesions look not unlike sago grains imbedded in the skin. In some instances the disease does not extend beyond this stage, the vesicles disappearing after a few days or weeks by absorption, and usually without desquamation. Ordinarily, however, the lesions increase in size, new ones arise, become confluent, and blebs result, the skin in places appearing as if undermined with serous exudation. The parts are commonly inflamed to a slight or marked degree. The skin comes off in flakes, new lesions may appear for several days or two or three weeks, and the process then declines, recovery gradually taking place.
There are no constitutional symptoms, although it is usually noticed that the general health is below par.
What is the character of the subjective symptoms in pompholyx?
The subjective symptoms consist of a feeling of tension, burning and tenderness, and sometimes itching. Not infrequently, also there is neuralgic pain.
What is the cause of pompholyx?
The eruption is thought to be due to a depressed state of the nervous system. It is more common in women, and is met with chiefly in adult and middle life.
What is the pathology?
Opinion is divided; some considering it a disease of the sweat-glands and others an inflammatory disease independent of these structures.
State the diagnostic features of pompholyx.
The distribution and the peculiar characters and course of the eruption.
It is to be differentiated from eczema.
What is the prognosis?
For the immediate attack, favorable, recovery taking place in several weeks or a few months. Recurrences at irregular intervals are not uncommon.
What is the treatment of pompholyx?
The general health is to be looked after, and the patient placed under good hygienic conditions. Remedies of a tonic nature, directed especially toward improving the state of the nervous system, are to be prescribed. Locally, soothing and anodyne applications, such as lead-water and laudanum, boric-acid lotion, oxide-of-zinc, boric-acid and diachylon ointments, are most suitable; or the parts may be enveloped with the following:—
℞ Pulv. ac. salicylici, ............................ gr. x
Pulv. ac. borici,
Pulv. amyli, ..................āā................. ʒij
Petrolati, ....................................... ʒiv. M.
In fact, the external treatment is similar to that employed in acute eczema.