Abstract
Pompholyx is an inflammatory vesicobullous disorder of the palms and soles. Although originally thought to be related to eccrine gland pathology, the condition is now considered to be part of the eczema spectrum. Pompholyx has a number of differential diagnoses and the etiopathology of this disease is not uniform. It can develop on the basis of atopy, contact irritation and contact sensitization, mycid reaction and as a side effect of drug treatment. Pompholyx treatment is challenging: topical therapy is based on corticosteroids and calcineurin inhibitors. Topical and systemic photochemotherapy and high-dose UVA-1 irradiation have been successfully used. Systemic therapy is often necessary in advanced cases of pompholyx. Corticosteroids are commonly used, sometimes combined with immunosuppressants. Alitretinoin has efficacy in chronic hand eczema including pompholyx. Another evolving treatment seems to be the intradermal injection of botulinum toxin. In practice, patients benefit most from a combination of treatments. Pompholyx may have a substantial negative impact on a patient’s professional life. A rare but severe complication is the development of secondary lymphoedema. Prevention requires antibiosis in case of suspected secondary infection and aggressive anti-inflammatory treatment. Later on in treatment, compression hosiery and lymph drainage might be helpful.
Financial & competing interests disclosure
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
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