Both dyshidrotic eczema and herpetic whitlow present with itchy blisters or bumps on the hands, which can make them difficult to differentiate.
Knowing the unique features of each can help distinguish between them. For example, dyshidrotic eczema is a type of eczema that can involve both hands and feet, while herpetic whitlow is a viral infection of the fingers.
This article looks at the signs and symptoms of dyshidrotic eczema versus herpetic whitlow. It also includes the underlying causes and treatments of each.
What is dyshydrotic eczema?
Dyshidrotic eczema, also known as hand and foot eczema, pompholyx, and dyshidrosis, is a type of skin condition characterized by the appearance of small, itchy blisters on the hands and feet.
Causes and risk factors
The exact cause of dyshidrotic eczema isn’t well understood, but it’s thought to be associated with certain factors such as seasonal allergies, stress, and exposure to irritants like nickel or cobalt.
People with a history of atopic dermatitis or a family history of dyshidrotic eczema are more prone to developing this condition.
Symptoms
Dyshidrotic eczema presents with small, clear blisters that typically develop on the sides of the fingers, the palms of the hands, or the soles of the feet. These blisters can look like tapioca pudding.
They are usually accompanied by itching and a burning sensation. Over time, the blisters may enlarge and eventually rupture, leading to cracking, peeling, redness, and pain.
Treatment
Mild cases of dyshidrotic eczema may not require any specific treatment. Emoillents and moisturizers may improve dry skin. Cold compresses can reduce itching. For more severe cases, your doctor may recommend topical or oral steroids or phototherapy.
What is herpetic whitlow?
Herpetic whitlow is a viral infection of the finger caused by the herpes simplex virus. There are two types of herpes simplex virus: HSV-1, usually responsible for cold sores, and HSV-2, often associated with genital herpes. Both types can cause herpetic whitlow.
Causes and risk factors
Herpetic whitlow is often seen in healthcare workers, such as dental hygienists, who come in contact with patients’ oral mucosa. It may also be seen in children who suck their thumbs. The virus enters through small cuts or abrasions in the skin.
Symptoms
Herpetic whitlow usually affects the tip of the finger. The condition begins with redness and swelling of the fingertip, followed by the formation of painful blisters.
The skin surrounding the blisters may appear red and swollen. In some cases, it may be accompanied by additional symptoms such as fever and swollen lymph nodes.
Treatment
Without treatment, the symptoms may last for 2-4 weeks. Antiviral medications, such as acyclovir, can reduce the duration of symptoms and lower the risk of spreading the virus to other parts of the body. Over-the-counter pain relievers can help manage the pain.
Similarities
Both dyshidrotic eczema and herpetic whitlow can affect the fingers and present with blisters. They both are painful and associated with itching. Because of these similarities, distinguishing between them can be challenging.
Differences
While they have several similarities, there are certain distinguishing factors that may help to differentiate between them:
- Location: Herpetic whitlow is usually localized to one hand, whereas dyshidrotic eczema usually appears on both hands. Dyshidrotic eczema can also involve the feet.
- Itching: Itching is usually more pronounced with dyshidrotic eczema than with herpetic whitlow.
- Associated disease: A person with herpetic whitlow may or may not have cold sores or genital herpes. Herpetic whitlow can be a complication of these conditions.
- Cause: The exact cause of dyshidrotic eczema is not known, while herpetic whitlow occurs due to an infection by a virus called the Herpes simplex virus.
- Contagious: Herpetic whitlow is contagious, and one can spread the virus to other parts of the body or to other individuals, while dyshidrotic eczema is not contagious.
- Trigger factors: Hot and humid environments and sweating can trigger dyshidrotic eczema, whereas herpetic whitlow is an infection, and sweat does not cause an outbreak.
- Treatment: The treatment depends on the severity of each condition. Dyshidrotic eczema is usually treated with steroids, while herpetic whitlow is treated with antiviral medications.
In most cases, a diagnosis can be made based on a physical examination of the lesions and medical history. In some instances, additional testing, such as viral culture, may be required to confirm the diagnosis.
If you suspect you have either herpetic whitlow or dyshidrotic eczema, it’s important to see a healthcare provider to get appropriate treatment.
References
- Calle Sarmiento PM, Chango Azanza JJ. Dyshidrotic Eczema: A Common Cause of Palmar Dermatitis. Cureus. 2020 Oct 7;12(10):e10839. doi: 10.7759/cureus.10839. PMID: 33173645; PMCID: PMC7647841.
Disclaimer: This article is for information purposes only and does not replace medical advice.