Dyshidrotic dermatitis

Case history

A 40-year-old woman presents with an intensely pruritic rash of the hands and feet that is relapsing-remitting. She recalls that 1 or 2 days prior to an eruption, she will notice an itching sensation in her palms and soles. The rash consists of small vesicles on the palms, soles, and lateral fingers. It lasts for a couple of weeks before desquamation, leaving no trace. She has several episodes a year and cannot cite specific triggers, although she does note that washing dishes makes it worse. Her medical history is otherwise unremarkable.