General Info

Causes of eczema

Types of Eczema

Eczema in specific localisations


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Hand/ Feet

Several different types of dermatitis such as allergic and irritant contact dermatitis, atopic dermatitis and idiopathic dyshidrotic eczema may cause eczematous lesions on the hands and/ or feet.

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Clinical picture:

The clinical picture is varied. Erythema, scaling, small blisters on the palms/ soles, in the interdigital and periungual areas, papules on the backs of the hands/ feet, painful fissures and hyperkeratoses on the palms and/ or soles may be present. The lesions are mostly accompanied by moderate to severe pruritus.


The diagnosis is based on careful history taking, clinical examination and possibly patch testing if allergies are suspected. Bacterial and mycological cultures may prove helpful in excluding superimposed infections. A skin biopsy may be useful to exclude other non-eczematous diseases.

Differential diagnoses:

Besides distinguishing between the above-mentioned etiologic factors for eczema on the hands/ feet, the following non-eczematous diseases must also be taken into account depending on the clinical features: With hyperkeratosis and fissuring: Palmoplantar psoriasis, diffuse types of palmoplantar keratoderma, Olmsted syndrome and palmoplantar keratoses in Sézary syndrome are possible differential diagnoses. With vesicles, oozing or bullae: Pustular psoriasis of the palms and soles, epidermolysis bullosa hereditaria, hand-foot-mouth-disease, acrodermatitis enteropathica and scabies in children are possible differential diagnoses for vesicles on the palms and soles. With erythema on the dorsal hand and fingers: dermatomyositis and lupus erythematodes must be taken into account. Uni Heidelberg