Case24

Back ground

A 34-year-old white woman was seen in consultation regarding a 1-month history of erythematous papules and bullae on the palms and soles. Associated intense pruritus was noted. Initial treatment with an over-the-counter antifungal cream was unsuccessful. The eruption worsened despite treatment with a first-generation cephalosporin and acyclovir, as provided by her primary care physician. There were no reported exposures to toxins, irritants, or potential allergens. The patient was on no other medications, vitamins, or supplements.


On examination, the patient demonstrated tense vesicular lesions on the lateral aspects of the digits of the hands and feet and also on the palmoplantar surfaces (Figure 1). These vesicles terminated abruptly at the wrists and ankles (Figure 2). There was little involvement of the dorsal surfaces. No targetoid lesions were noted. The conjunctiva and oral and genital mucosa were within normal limits. No other cutaneous abnormalities were noted on examination.

What is most likely diagnose?





Answer is "b" Dyshidrotic dermatitis/pompholyx.