Dyshidrotic Eczema (Pompholyx) Differential Diagnoses

Updated: Apr 22, 2020
  • Author: Sadegh Amini, MD; Chief Editor: William D James, MD  more...
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DDx

Diagnostic Considerations

Conditions to consider in the differential diagnosis of dyshidrotic eczema include the following:

  • Dyshidrosiform pemphigoid - May have vesicles (vesicular pemphigoid) or may be evident as erythema and swelling, with bullae on the palmoplantar areas [26] (In fact, bullous pemphigoid may closely resemble recurrent vesicular hand eczema. [27] )

  • Inflammatory tinea pedis or tinea manus

  • Palmoplantar pustular psoriasis

  • Pustular bacterid

  • Pustular psoriasis

  • Recurrent focal palmar peeling (previously termed keratolysis exfoliativa) [28]

  • Dyshidrosis-like variant of adult T-cell leukemia/lymphoma [29]

  • Bullous impetigo

  • Juvenile plantar dermatosis

  • Linear IgA-disease with (hemorrhagic) pompholyx

  • Vesicobullous mycosis fungoides/Sézary syndrome

  • Keratolysis exfoliativa: Intermittent air-filled blisters and centrifugal collarette of the palms and soles; histopathologically characterized by cleavage within the stratum corneum and partial degradation of corneodesmosomes in the mid stratum corneum; normal expression of corneodesmosomal components reported by immunofluorescence; no mutations in SPINK6⁄9 have been found; no association with dyshidrotic eczema, dermatophytosis, acral peeling skin syndrome, or localized epidermolysis bullosa simplex [28]

Differential Diagnoses