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A 3-year causative study of pompholyx in 120 patients
Marie Hélène Guillet1, Ewa Wierzbicka, Stephanie Guillet
1Department of Dermatology, Centre Hospitalo-Universitaire de Poitiers, 2 Rue de la Milétrie, BP 577, 86021 Poitiers CEDEX, France. gerard.guillet@chu-poitiers.fr
Objective:
To assess the relative frequency of the different causes of pompholyx evoked in the literature.
Design:
Prospective survey.
Setting:
Clinical outpatient setting.
Patients:
A total of 120 consecutive patients with pompholyx referred to our department from 2000 through 2003.
Main Outcome Measures:
Systematic investigation of different causes of pompholyx: fungal intertrigo, hyperhidrosis, atopy, contact eczema, and internal reactions with systematic provocation tests to metals, balsam of Peru, and food allergen when suspected.
Results:
The present study found the following causes of pompholyx in the 120 patients: mycosis (10.0%); allergic contact pompholyx (67.5%), with cosmetic and hygiene products as the main factor (31.7%), followed by metals (16.7%); and internal reactivation from drug, food, or haptenic (nickel) origin (6.7%). The remaining 15.0% of patients were classified as idiopathic patients, but all were atopic. (Percentages do not total 100 because of rounding.)
Conclusions:
Our data confirm the existence of reactional pompholyx to interdigital-plantar intertrigos and endogenous reactions to metals or other allergens, but they mainly point at the unexpected importance of a so-called contact pompholyx in which cosmetic and hygiene products play a preponderant role compared with metals. The great frequency of atopic conditions, even if idiopathic pompholyx is not inferred as an equivalent of atopy, should lead to further causative investigations before undertaking more expensive or extensive treatments of refractory pompholyx.
Insights
This study found allergic contact dermatitis, particularly from cosmetics and hygiene products, is the leading cause of pompholyx. Atopic conditions are also frequent, even in idiopathic cases, warranting further investigation.
Area of Science:
- Dermatology
- Allergology
- Epidemiology
Background:
- Pompholyx, also known as dyshidrotic eczema, is a skin condition characterized by vesicles on the hands and feet.
- The exact causes of pompholyx are diverse and not always clearly identified, necessitating further research into its etiological factors.
Purpose of the Study:
- To determine the relative frequencies of various causes of pompholyx.
- To investigate the role of different triggers, including contact allergens, internal reactions, and underlying conditions like atopy.
Main Methods:
- A prospective survey of 120 consecutive pompholyx patients in a clinical outpatient setting.
- Systematic investigation included fungal intertrigo, hyperhidrosis, atopy, contact eczema, and internal reactions with provocation tests for metals, balsam of Peru, and food allergens.
Main Results:
- Allergic contact pompholyx was the most frequent cause (67.5%), with cosmetics and hygiene products being the primary triggers (31.7%).
- Metals accounted for 16.7% of contact pompholyx cases. Mycosis (fungal infections) and internal reactions (drugs, food, nickel) were less common (10.0% and 6.7%, respectively).
- Idiopathic cases (15.0%) were all associated with atopy.
Conclusions:
- Contact pompholyx, especially due to cosmetics and hygiene products, is more prevalent than previously thought.
- The high incidence of atopy in pompholyx patients, including those with idiopathic cases, suggests the need for thorough etiological investigations before initiating extensive treatments.
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