The reality is that antihistamines are safe medications with very few adverse effects and can be used with confidence if necessary. The question is whether they should be used in people with atopic dermatitis.

Surely your pediatrician or doctor has prescribed them to you “for the itching” at some point, and yes, they may have provided some relief… but have you seen any improvement in the areas of dermatitis? Have you seen the redness and flaking disappear? Is the relief really that great? If it is the inflammation of the skin that causes the itching and antihistamines do not seem to improve it, do you think there is any point in taking them?

Let’s see what the scientific evidence says about this.

How do antihistamine pills work?

As their name suggests, these compounds block histamine receptors, which cause allergies, hives, and some types of itching in our bodies. Specifically, type 1 antihistamines are used for these conditions, as type 2 antihistamines are usually used for digestive conditions that have nothing to do with what we are talking about.

There are two types of type 1 antihistamines:

• Sedatives: these are drugs that are able to cross the blood-brain barrier, reach the brain, and have a mild sedative effect. They make us sleepy. Examples of this type include Polaramine® and Atarax®.
• Non-sedatives: these are the most commonly used, especially for seasonal allergies, as they do not cross the blood-brain barrier and therefore do not cause drowsiness. Other antihistamines you may be familiar with belong to this type: loratadine, desloratadine, cetirizine, ebastine, bilastine, etc.

  

Are antihistamines commonly used?

A recent publication by the JAAD revealed that 22% of patients with atopic dermatitis who visited a dermatologist in the US were prescribed an antihistamine, usually of the sedative type. Pediatricians also prescribe this type of antihistamine in 16% of cases. However, non-dermatologist specialists prescribe non-sedating antihistamines in approximately one in three patients.

I believe that these data may reflect what is happening in our country as well.

Are antihistamines effective for the itching associated with atopic dermatitis?

The reality is that numerous scientific studies, reviewed by the Cochrane Library, show that antihistamines do not actually reduce itching in atopic dermatitis. Of course, they are not useful for improving eczema.

It is known that in many cases, people with atopic dermatitis take them because they relieve other symptoms also related to atopy, such as allergic rhinitis, conjunctivitis, or food allergies.

Just because they are prescribed does not mean they are effective. In many cases, we give them with the idea that, as sedatives, they can help you fall asleep and have a better night’s sleep by “masking” the itching. However, it has been found that these medications can worsen sleep quality by shortening REM sleep. Not only that, but if their effect persists in the morning (which it often does), they can interfere with learning ability and memory.

So what are the recommendations?

You know that the star treatment for atopic dermatitis is topical corticosteroids. In some cases, we also resort to calcineurin inhibitors. And it is on these two pillars that we must focus the treatment of atopic dermatitis in children and adults to control outbreaks. Obviously, all this must be accompanied by appropriate care and moisturizing measures, which I already mentioned in another article.

I’m not the only one saying this; the American Academy of Dermatology advises against the use of antihistamines exclusively to control the itching of atopic dermatitis. They can, of course, be used in people who, in addition to their dermatitis, suffer from another condition that clearly improves with these medications (rhinitis, conjunctivitis, etc.).

I hope this article has answered your questions about antihistamines.

Do you usually use them for your dermatitis or your child’s? Do you find them useful?

If you have any further personal questions, I can help you through the online consultation.

The post Atopic dermatitis and antihistamine pills first appeared on Dra. LOREA BAGAZGOITIA.

This post is intended to provide some basic advice on how to manage this condition in the best possible way.

We must bear in mind that itchy skin is very uncomfortable and causes people with atopic dermatitis to suffer: they may become more irritable (especially young children), more nervous and even sleep worse. All of this has a significant impact on quality of life, which, in my opinion, is unacceptable, as we have various measures and treatments available to prevent it. The aim is to minimise the areas of red, rough skin, which are outbreaks of eczema or dermatitis, causing itching and discomfort.

Atopic dermatitis affects quality of life

It can be said that there are two important actions: treating areas of dermatitis and preventing them.

PREVENTION: to prevent a flare-up

The structural ‘defect’ in the skin of people with atopic dermatitis makes it drier and more sensitive than other people’s skin. Here are some tips on how to take the best possible care of your skin in order to prevent new outbreaks of dermatitis.

• Moisturize your skin thoroughly: the more moisturizer you use, the better, but you should always apply it after showering.
• Take baths/showers that are neither too long nor too short. Likewise, the water should be neither too cold nor too hot, as extreme temperatures can also irritate the skin. Long baths can increase skin dryness. The key is moderation.
• Use mild gels or shower oils, avoiding detergents and soaps that are harsh on the skin. Do not use irritating products that damage the skin (exfoliants, horsehair gloves, etc.).
• Cut your nails as short as possible to avoid scratching.

TREATMENT: when there is already an outbreak of dermatitis

To do this correctly, although it may seem obvious, it is important to differentiate between “skin with dermatitis” and “healthy skin”:

• Skin with dermatitis: it usually looks red and feels rough to the touch. It also itches. This is easy to notice in children because they scratch continuously. Sometimes cracks or small wounds can be seen.
• Healthy skin: skin that is normal in color and completely smooth to the touch. No itching.

Dermatologists usually prescribe some type of corticosteroid cream (or other “more sophisticated” creams called immunomodulators, such as Elidel® or Protopic®) to treat skin with dermatitis. This should be applied once or twice a day until the skin feels smooth and free of redness again. If there are small wounds or cracks, the cream can still be applied.

I will discuss this in another post, but we should not be afraid of treatment with corticosteroid creams, as they are a safe treatment and are key to good control of atopic dermatitis. If a flare-up occurs, they should be applied; the mistake would be to use them regularly on healthy skin.

When dermatitis flares up periodically, treatment with the cream prescribed by the dermatologist should be started as soon as the first symptoms are observed (a little redness, itching, or flaking). We should not wait until the dermatitis is severe (very red, flaky, and cracked) to apply the cream, as the later we start, the longer we will have to endure the discomfort and the more days of treatment with corticosteroid cream we will need. By starting treatment as soon as the area with dermatitis appears, we will probably only need a few days of application for it to heal.

Corticosteroid creams are key to treating atopic dermatitis. When applied properly, they are a safe treatment.

There may be cases in which, despite applying the cream for several days, the areas affected by dermatitis do not disappear or even spread. In these cases, which are less common, it is advisable to consult a dermatologist because oral treatment may be necessary.

Moisturizer should not be applied to areas with dermatitis.

Moisturizers, which are very useful for preventing new outbreaks, usually irritate areas with dermatitis, and it is therefore advisable to avoid applying them to these areas. We will use them on healthy skin as a preventive measure, avoiding areas with dermatitis.

The post Basic tips for atopic dermatitis first appeared on Dra. LOREA BAGAZGOITIA.

Atopic dermatitis is a condition that we consider chronic. This means that it lasts for a long time; it is usually treated, gets better and then reappears a few days, weeks or months later.

If this is your case or that of your little one you may be at the point of asking yourself, “Will this be like this forever?”

It is very normal to ask this question and that is why in this article I will try to tell you what we know so far about how atopic dermatitis evolves throughout life.

Atopic dermatitis: a childhood disease?

Traditionally it has been considered a disease of children, especially babies. At that age eczema appears and by puberty it will disappear: this is what was said globally.

The reality is that atopic dermatitis is not only a children’s disease, nor can all children be cured by atopic dermatitis.

Let us look at the figures: it is estimated that in industrialized countries up to 20% of children suffer from atopic dermatitis, i.e. 1 in 5.

In recent years, some research has been carried out to characterize what will happen to those children who start with dermatitis in infancy. In a work done in 2013 in Germany it was seen that most of the time (in 40.9% of the cases) the disease starts before the age of 2 years and 16.6% will start before the age of 6 years.

Of these children (as you see in the image below) 3 out of 4 will continue with symptoms of atopic dermatitis throughout their lives, probably into adulthood. There will be a small percentage that will be cured and one fifth of them will improve at puberty, presenting outbreaks again in adulthood (Note, the percentages you see in the image represent the subgroups within the 40.9% I mentioned above that start before the age of 2 years).

Throughout childhood, however, the form of the dermatitis evolves, so that in younger babies it usually affects the cheeks in the extension areas and with time it becomes more localized in the flexion areas. In this link about dermatitis according to age you can read more about these changes.

Atopic dermatitis: also in adults

The prevalence of atopic dermatitis among adults varies according to sources between 2 and 10%. Its presence is a reality and this can occur in several contexts.

On the one hand, it may be an adult who has had atopic dermatitis since childhood, being one of those children mentioned in the previous section. Normally these people, in addition to dermatitis, have a higher frequency of other allergies, rhinitis or asthma, as a result of the “atopic march” about which I have already spoken to you in other articles of this blog.

In 13 % of the cases, dermatitis starts in adolescence. In these people, there is an almost total probability that it will continue into adulthood.

The same is true for people in whom it starts after the age of 18, which is increasingly common and is the case for almost 25% of adults with atopic dermatitis. These people have a low prevalence of other allergies, unlike those with childhood onset.

Atopic dermatitis is much less common but can also debut with atopic dermatitis, even after the age of 60.

In summary…

Atopic dermatitis is a disease more frequent in children, but not exclusive. Recent studies show a great variability. Many of the babies who suffer from it, continue to present it as adults and in many other cases, the dermatitis starts after the age of 18.

Do you have atopic dermatitis and at what age did it start?

The post Can atopic dermatitis be cured? first appeared on Dra. LOREA BAGAZGOITIA.

There are some basic measures in the daily life of people with dermatitis that we are going to review below:

Moisturizer is your best ally

Skin with atopic dermatitis has an altered lipid mantle, which causes it to lose water through its surface more easily than non-atopic skin. Emollient creams help replenish the naturally defective mantle, making it easier to retain water and decreasing the likelihood of inflammation in the area.

However, if you have dermatitis, you’ll know that moisturizer on red, flaky areas stings a lot. So how to proceed? Let’s move on to the next point.

Treatment: the sooner the better

If the skin is scaly, red and/or itchy, it is likely that it is not healthy skin, but already has some degree of inflammation, i.e. it is a dermatitis outbreak.

At this point, the moisturizing cream is not able to reverse the inflammation that is occurring, and as the skin surface is altered, contact with the components of the cream generates discomfort.

The interesting thing at this point is to reduce inflammation and for this nothing better than drugs such as corticosteroids or calcineurin inhibitors. The sooner you apply them, the shorter the duration of the outbreak, the less annoying you will be and the easier it will be to tackle the problem.

Shower or bath: no fixed rules

On many occasions I have heard people advise showers versus baths, as well as decreasing the frequency of baths. The reality is that at present there is still no clear scientific evidence about what is best, and there is no reason to advise against one or the other.

In general, we can do whatever makes us feel most comfortable in terms of hygiene. The important thing is to always apply moisturizer after showering or bathing as (this has been proven) this is the best time to do so. Applying the emollient after most of the water has been removed from the skin surface but while it is still damp allows for greater retention of moisture and greater effectiveness of the moisturizer we are using.

Fragranced cosmetics: the fewer the better

People with atopic dermatitis have an increased risk of becoming sensitized to certain molecules, i.e. becoming allergic to them. We are not talking about allergies that cause asthma or urticaria, but allergic contact dermatitis. People with contact allergy develop eczema (outbreaks of dermatitis) similar to atopic dermatitis after contact with a particular substance (metal, colorants, dyes, preservatives ….).

Perfumes are present in a lot of cosmetics. Knowing that, if you have dermatitis, the risk of developing some sensitization is higher, it is generally advisable to use low perfumed products in order to avoid this complication.

If you do not improve, talk to your dermatologist

You may have followed these guidelines with all the rigor in the world. You may have applied moisturizer daily and treated your outbreaks with discipline right after their appearance and yet you see that you are not improving, that your skin itches and the treatment does not help.

In this case, talk to your dermatologist. Chances are you are not doing it wrong. There are simply cases of atopic dermatitis that cannot be managed with creams alone. Fortunately, there are other treatment options that your dermatologist can explain to you. The goal is to avoid discomfort and itching so that they have the minimum impact on your quality of life and that you feel well, which is what is really important.

Do you have atopic dermatitis and how do you manage it?

The post How to take care of atopic skin first appeared on Dra. LOREA BAGAZGOITIA.

There are many types of pimples that can appear in children, such as molluscum contagiosum or millium cysts. Acne can also appear at a very young age, in teenagers, or even in adult women. Rosacea can also cause pimples on the face.

With so many forms of pimples, what is wrong with you (or your little one)?

Well, if these pimples are not painful and are always there, stable, especially on the arms, thighs or cheeks, it is most likely keratosis pilaris.

What is keratosis pilaris?

They are non-itching, sometimes slightly red pimples that make the skin feel rough.

They are often found on the arms and thighs, but it is not uncommon to see them on the face, although they can also appear on other areas such as the forearms or trunk.

It is more common in children, but many people continue to have this skin type into adulthood. It is most common in people with atopic dermatitis, obesity, ichthyosis, type 1 diabetes, or Down syndrome.

More images of keratosis pilaris

How is it diagnosed?

Tests are usually not needed. A simple physical examination can easily lead to a diagnosis. It is important to distinguish this condition from other conditions that can cause pimples.

Why does it appear?

Keratosis pilaris is not an infection or allergy. It does not indicate an internal disease, nor is it a type of persistent acne. Let’s say that it is something “constitutional” of the person who has it: in the hair follicles of their arms and legs, small keratin plugs are formed, which are the ones that we observe and scratch to the touch.

Is it forever?

In most cases (especially in children), it gets better over time. In addition, pimples usually become less visible during the summer. This is attributed to less rubbing by the sleeves of clothing, but the reality is that we do not know this clearly.

How can it be improved?

Because this is specific to your skin type, it cannot be permanently cured, but there are ways to help make your skin smoother and the pimples less noticeable.

• Apply moisturizer. Just as proper hydration and replenishment of the lipid mantle softens the skin, it also makes pimples less noticeable.
• Exfoliate: You can do this with a glove, exfoliating cream brush. This procedure physically removes the keratin that clogs the pores.
• Use products with some urea, salicylic acid or lactic acid. These chemically break down the keratin, so if you use them daily, they can reduce the volume of pimples.
• If you do not see sufficient improvement, see a dermatologist. Occasionally, if the above measures are not sufficient, treatments such as retinoids or corticosteroids can be used to boost the improvement of the pimples. Of course, everything has to be controlled by a dermatologist.

In conclusion…

Keratosis pilaris is not a serious condition, but it can be annoying and aesthetically unpleasing. It can last for years and if you want to improve it, you can use different creams that soften the pimples by chemical or physical exfoliation. If this is not enough, consult a dermatologist.

Would you like me to evaluate your specific case? Make an online dermatological consultation with me and together we will find the best creams for your case.

The post Pimples on arms, legs and face first appeared on Dra. LOREA BAGAZGOITIA.

As I mentioned in another post about atopic dermatitis and its treatment, one of the mainstays of treatment is corticosteroid creams, emulsions or ointments. In people with this disease, the balance of benefits and risks of this treatment is clearly on the side of benefit, although it is important to be aware that corticosteroid creams are a drug and not just another moisturizer; therefore, their use should be indicated by a pediatrician or dermatologist.

In atopic dermatitis, the benefit of topical corticosteroids outweighs their risks.

The purpose of this article is not to scare people about the risks of topical corticosteroids, but rather to provide information to help alleviate some of the (unfounded) fears surrounding this very useful and important treatment for people with atopic dermatitis.

The purpose of this post is to inform and reassure about the use of corticosteroid creams.

1. How do topical corticosteroids work in atopic dermatitis?

Topical corticosteroids are used primarily for their anti-inflammatory effects. The drug penetrates the inflammatory cells found in dermatitis skin and reduces certain mechanisms that cause inflammation locally. They are usually used when basic hygiene and hydration measures are not sufficient. More than one hundred randomized clinical trials (the highest quality scientific studies) have been published in the scientific literature demonstrating their efficacy for atopic dermatitis.

Topical corticosteroids act by reducing inflammation and are classified according to their potency.

There are 7 groups into which they are divided according to their potency in reducing inflammation. The dermatologist (this could be done through a consultation with an online dermatologist) will indicate the most appropriate depending on where it should be used and for how long.

2. WHAT ARE THE SKIN RISKS?

In general, the risk of topical corticosteroids is very low, especially when used according to a dermatologist’s guidelines. I will describe below the problems that can occur as a result of their use, but I would like to make it clear that they are all generally due to inappropriate and abusive use over very long periods of time. Even when atopic dermatitis lasts for years and repeated cycles of one or more topical corticosteroids are performed, it is rare to achieve any of the effects you will read about below.

• CUTANEOUS ATROPHY: The use of strong corticosteroids (which we rarely prescribe, especially in children) can cause skin atrophy. This is a significant thinning of the skin, which resembles cigarette paper, and can cause stretch marks, which can make the veins under the skin more visible.

This is extremely rare in the treatment of atopic dermatitis because super-potent corticosteroids are not usually used, and if they are used, it is on an ad hoc basis. One study showed that continuous use of fluticasone (one of the most commonly used corticosteroids in children) on the same skin for 10 weeks did not cause atrophy.

• ROSACEA-LIKE ERUPTION: Continuous use on the face can cause the appearance of pimples and pinker skin in the area of use, which is almost indistinguishable from rosacea, which I will talk about in another post. This is usually seen in adults who have been using a corticosteroid on the face for years without medical control and is therefore extremely rare in children.

• OTHER SKIN CHANGES: Other less common skin changes may include lightening of the skin color (e.g., in Asia and Africa, they have been used to depigment the skin) or the appearance of more hair.

It is common in children with atopic dermatitis to see areas of lighter skin, which tends to be more noticeable in the summer. This color change is called dartros or pityriasis alba and is due to the atopic dermatitis itself and not to topical corticosteroids, as is often thought.

• CORTICOID ALLERGY: It is very rare, but it is possible to be allergic to a certain type of corticosteroid cream; this is suspected when a person does not improve at all or even gets worse after using a certain corticosteroid. As I said, it is rare, but if it is suspected, specific tests should be done to confirm it.

3. What are the risks to the REST OF THE BODY?

You may have heard many times that corticosteroids (or as they say, “cortisone”) are bad because they can raise blood pressure, make us swell or cause diabetes (elevated blood sugar). These are well-known side effects of corticosteroids, but they usually occur with long, systemic (i.e., oral or intravenous) treatments.

It is very rare for topical corticosteroids to cause systemic effects after appropriate use.

When applying a cream, emulsion, or ointment, depending on the area of the body, some of the medication may enter the bloodstream, but this amount is negligible in most cases. However, this should be taken into account in areas such as the folds of the skin, the genitals, or the eyelids, where the skin is so thin that the proportion of the drug that enters the blood is greater (compared to, for example, areas such as the palms of the hands or the forehead). In any case, it never reaches half of the amount applied.

Therefore, it is rare for blood levels to cause the typical manifestations of systemic corticosteroids. In any case, we have to keep in mind that this could happen if the treatment is abused; therefore, it is important to follow the advice of a dermatologist (whether online or in person) who will adjust the dose and type of corticosteroid according to the area or extent where it is to be applied.

4. ARE THERE ALTERNATIVES to its use?

There are alternative treatments to topical corticosteroids, but in my opinion they should not replace corticosteroids, but may be useful to supplement treatment in some cases.

Topical pimecrolimus and tacrolimus are alternative treatments to topical corticosteroids.

These treatments are topical calcineurin inhibitors (tacrolimus and pimecrolimus). These are also medications that have been shown to be safe in the long term, but I will discuss them in more detail in another post.

The post 4 questions about corticosteroid creams for atopic dermatitis first appeared on Dra. LOREA BAGAZGOITIA.

WHAT IS Dyshidrotic Eczema or Pompholyx? – Symptoms

We call dyshidrotic eczema, dyshidrosis, or pompholyx the small bubbles, pimples, or blisters that appear on the sides of the fingers and toes. They may also extend to other areas of the palms or soles. The appearance of these vesicles is relatively common and may account for up to 20% of hand eczema cases. It can appear at any age, although it is more common before the age of 40.

It is characteristic that blisters appear on the sides of the fingers that are very itchy.

It may occur only on the hands (most frequently), only on the feet, or on both sites. They are usually small vesicles (which in more severe cases may become blisters) on the sides of the fingers. These may become superinfected (in which case they become more yellowish). The vesicles break with time and gradually flake off. Sometimes small cracks form on the skin, which can be annoying. This rash is notably very itchy.

Outbreaks may last several weeks and recur periodically.

Here you can see more pictures of dyshidrotic eczema.

WHY does Dyshidrotic Eczema or Pompholyx Break Out? – Cause

In my experience with patients with dyshidrotic eczema, in the vast majority of cases, there is no clear cause for its occurrence. Dyshidrotic eczema (like so many other skin diseases) is capricious. It usually appears suddenly and can disappear just as suddenly (although, as we will discuss later, there are treatments available to improve it). However, it is more frequent in people with atopic dermatitis or other types of eczema.

It is known to be more common in warmer climates. It can flare up in times of increased stress and worry, and some cases have been associated with fungal infections, smoking, and some intravenous treatments. In any case, the most common scenario is that the cause is unknown.

Although the exact cause is not known, it has been found that sweating does not influence the appearance of the disease.
Vesicles finger dyshidrotic eczema.

It used to be thought that dyshidrotic eczema was related to sweating of the feet and hands, and that the blisters formed when the sweat glands became occluded. To date, this hypothesis has been discarded, as no evidence or demonstration of this supposed mechanism has been found.

HOW IS Dyshidrotic Eczema or Pompholyx Diagnosed? – Diagnosis

First of all, it is important to differentiate it from other diseases that can cause skin pimples (psoriasis, other eczemas, fungal infection, scabies, etc.). Dyshidrotic eczema can usually be diagnosed with a simple clinical examination. Dermatologists do not usually need specific tests to recognize it. In rare cases, if a good response to treatment is not observed, a biopsy, culture, or certain allergy tests may be necessary.

On the other hand, it is important to confirm in any case that the dyshidrotic eczema is not caused by a contact allergy to some substance or material that the person touches on a daily basis. This is called allergic contact eczema and may be due to metals, fragrances, rubbers, preservatives, or dyes. Dyshidrotic eczema and contact eczema can manifest in very similar ways. To determine if this is the cause, contact tests can be performed, and if sensitization is confirmed, by eliminating the causative factor, the symptoms of eczema will disappear.

HOW IS Dyshidrotic Eczema or Pompholyx Treated? – Treatment

Measures such as using mild soaps, wearing gloves, and avoiding irritating products can help improve dyshidrotic eczema. In many cases, eczema may heal on its own after a few weeks.

First, it is not enough to use moisturizer. Cosmetics alone do not have the ability to control eczema and can even make it worse.

Second, the most commonly used treatment is corticosteroid creams. These, in most cases, reduce itching as well as the appearance of vesicles and desquamation. The treatment may last several days or weeks. In more severe cases, oral corticosteroids or other treatments (such as phototherapy in rare cases) may be necessary.

Dyshidrotic eczema may heal on its own, but in most cases, it is treated with corticosteroid creams. However, it is important to know that, even with proper treatment, eczema may have a tendency to recur. Many times it may be necessary to use the treatment repeatedly or even to use a maintenance treatment. Your dermatologist can advise you on how to do this.

How Does Dyshidrotic Eczema or Pompholyx Evolve? – Prognosis

In my experience, it is really important that sufferers of dyshidrotic eczema understand its recurrent nature. The itchy blisters and pimples that appear on the hands and feet usually reappear periodically. It is also common for outbreaks to occur during times of increased stress or worry.

As I often say in my practice, we do not know how to cure dyshidrotic eczema, but we do know how to manage it. Consequently, it is highly recommended that those suffering from this condition have the necessary tools to control the outbreaks and symptoms caused by dyshidrotic eczema, always with the guidance of their dermatologist. Ultimately, it will be the patient themselves who best controls which treatment cream to apply and at what time it is best to apply it.

Psychological Impact of Dyshidrotic Eczema or Pompholyx

Itching is the worst symptom caused by dyshidrotic eczema. The rupture or erosion of the blisters also causes a lot of discomfort to sufferers. Beyond the purely dermatological symptoms, we know that people with dyshidrotic eczema may feel affected or withdrawn in their personal relationships. Having their hands permanently “bad” together with the frustration of not achieving adequate control means that the psychological repercussions of dyshidrotic eczema can be significant.

In this sense, from my experience as a dermatologist, I believe it is important to understand that dyshidrotic eczema can be controlled and improved. Moisturizing cream alone is not enough (in fact it often makes it worse) and it is necessary to use medicated creams (usually with corticosteroids). Using the right guidelines, it is possible to control it and prevent its reappearance.

Therefore, in my opinion, it makes no sense to resign oneself to outbreaks. The help of a dermatologist who is an expert in pompholyx can alleviate and improve the repercussions on the daily life of the sufferer.

In conclusion…

Dyshidrotic eczema is not a sign of any internal disease, it is not contagious, and it is not related to sweating of the hands or feet. It can be treated with topical corticosteroids, but it may have a tendency to recur, as it follows a “capricious” course. Its exact cause is not known at this time.

The post ITCHY BLISTERS ON HANDS AND FEET: PONPHOLYX first appeared on Dra. LOREA BAGAZGOITIA.