Sweat blisters are the most common type of hand eczema. The name was used to describe blistering eczema on the palms of the hands and soles of the feet more than 100 years ago, when it was believed that blisters on the hands and feet were caused by poor sweating or sweat retention. In fact, the occurrence of herpes sweat is not directly related to abnormal sweat gland function, but the name herpes sweat has been used to this day, causing much misunderstanding and confusion. A lot of patients ask “is herpes sweat caused by sweaty hands” when they visit the clinic.
I. Synonyms of herpes sweat
There are many other names for herpes sweat: acute palmoplantar eczema, sweating hand eczema, sweating hand eczema, acute recurrent blistering hand dermatitis, but these names are all descriptive diagnostic terms that are essentially the same, but different doctors will use different names for diagnosis.
Second, the cause of sweat blisters
It is not fully understood, and for most patients the cause is not fully determined. It is thought that a number of factors may be involved in the development or aggravation of herpes sweat.
1. inherited allergic constitution (e.g. history of atopic dermatitis/eczema).
2. exposure to a number of allergens, most commonly the metals nickel, chromium, cobalt, etc.
3, exposure to some irritants, especially in wet work and metal processing industries.
4. fungal infections of the feet or other distant parts such as tinea pedis.
5, patients treated with intravenous immunoglobulin.
6, excessive sweating of the hands (excessive sweating is not a direct cause but an aggravating factor).
7, smoking.
8, ultraviolet radiation.
9, emotional stress.
Third, the manifestation of herpes perspicans
Sweat blisters are usually confined to the hands and feet, initially manifesting as itching, burning and tingling sensations on the palms and soles of the feet, followed by the appearance of rice-grain-sized blisters, which can only be felt as pebble-like elevations when touched due to the thicker skin on the palms and soles of the feet in the early stages. Sweat blisters mostly occur on the fingers, palms or soles of the feet, but can also be combined with other types of eczema on other parts of the body. If the blisters rupture and ooze, they can easily become infected with bacteria, causing redness, pain, and pustules. After the blisters are absorbed, the skin will peel, redness, dryness, and cracking will occur. The skin around the nails and nails can also be involved in nail fungus.
Fourth, the treatment of herpes sweat
First, it is important to avoid contact with all suspected aggravating factors, such as avoiding the use of soaps and detergents, and reducing exposure to water. If the skin is oozing, it is recommended to use a 1:5000 potassium permanganate soak or wet compress (potassium permanganate dissolves in water and turns pink in color) 1-2 times a week. Soak hands or feet in the solution or apply a wet compress with gauze for 10-15 minutes, then rinse with water and pat dry.
Once the acute exuding rash has resolved, then the soaking or wet compresses should be stopped and replaced with topical glucocorticosteroids. Topical glucocorticosteroids control the inflammatory skin response but may dry out the skin, so emollients need to be used frequently. If you have painful, oozing, yellow crusts on your hands or feet, you may have a combined bacterial infection and your doctor will prescribe topical or oral antibiotics, depending on the situation.
Severe cases of sweat blisters require oral retinoids (alivaptan) or topical ultraviolet light therapy. Short-term oral glucocorticoid therapy may also be considered for fulminant patients, and these systemic medications need to be prescribed by your doctor.
V. Daily care tips for herpes perspicans
Excessively hot or cold water may cause skin irritation. Avoid using alkaline soap when cleaning and use emollients frequently after cleaning. Try to avoid direct contact with any cleaning agents or detergents. You can use cotton-lined gloves instead of ordinary rubber or plastic gloves. During the acute phase of herpes, it is recommended to wear cotton-lined gloves when doing household chores or washing and bathing hair, or to go to a barbershop to have your hair washed or have someone else do the chores if possible.
If the itching is severe enough to interfere with sleep, oral antihistamines with sedative effects can be taken at night to help with sleep. If the blister is too large, you can use a sterile syringe to gently tear a small jagged opening in the blister (simply puncturing it with a needle is useless because the fluid will not flow out and the blister will soon close up) and drain the blister. However, the blister wall should be retained and covered in its original place, otherwise it will increase pain, delay healing and increase the risk of infection.
Bandaging the hands or feet after applying the medication helps to moisturize the skin, or you can wear cotton gloves or socks. Shoes should be kept dry and breathable; try to avoid plastic or rubber shoes; leather-lined shoes are a good choice. In addition, absorbent insoles, especially those that can be washed and dried frequently, are recommended. Having several pairs of shoes to replace can also help avoid wet shoes. If sweat rash occurs repeatedly on the feet, be aware of the possibility of chromate allergy, which is often used in the leather production process or as an adhesive in rubber shoes, and this can be clarified by doing a patch test.