Wednesday, October 5, 2011

A variant of eczema...Pompholyx

Most often when people think of eczema they don't realize that there are variations of this disease.  A very common subtype of eczema is pompholyx eczema.  It accounts for about 20% of eczema cases seen and affects the fingers and palms as well as the soles of the feet and toes.  About 80% of pompholyx cases affect the hands and 20% affect the feet.  What makes this form of eczema so unique is that it tends to form vesicles that can either rupture or be reabsorbed into the skin.  In both cases, the vesicular phase which last for about one to two weeks is followed by a dry phase during which scaling can occur.  In the case of the ruptured vesicles, exudate can form as well as crusting.  This form of eczema is also referred to as dishidrotic eczema since it is commonly seen in individuals with excessive sweating of the palms and soles.  It was once thought that the sweating was the cause of this form of eczema but this is not the case. 

Pompholyx eczema tends to go through a cyclical pattern.  It begins with the vesicular phase and then transforms into a dry phase.  In the vesicular phase, small pearly white vesicles form on the skin surface of the palms, soles and/or between toes and fingers.  These vesicles can coalesce and form larger more painful bullae.  If these vesicles or bullae rupture, yellow or white exudate will be expressed from the lesions as well a blood tinged crusting.  When vesicles rupture the epidermis is damaged and this can lead to erosion of the skin surface.  In the case of erosion, crusting is almost always present.  During the dry phase, we begin to see scaling, fissures, and/or lichenification (thickening of the skin).  In more chronic cases of pompholyx eczema lichenification and fissures will be seen due to the continued assault on the skin.

When seeking help for this condition, Chinese herbal medicine should be the first treatment approach utilized. Those using Chinese herbs respond quite well to this stubborn skin condition.  Both internal and topical herbs can be used to address the problem from the root and branch thereby eliciting a shift in the body.  By utilizing this modality the body can be rebalanced and the disease stabilized while discontinuing the herbs following a course of treatment.  Unfortunately, many people are unaware of the effectiveness of these modalities and seek out conventional medical treatments.  These types of treatments can be detrimental to the already damaged tissue.  Most treatments will include the use of strong topical steroids due to the thick nature of the skin where pompholyx eczema manifest's itself.  These steroids must be used long term to keep the condition under control.  Using these agents for an extended period of time will result in displacement of the fatty tissue thereby thinning the skin and weakening the structure and ultimately slowing the healing process.  As with all steroid use, inflammatory processes are suppressed during their use but will rebound once the inhibitory agents are discontinued.  If you would like to address such a skin concern naturally, please contact the clinic.

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