It usually starts as sore, itchy patches. food allergies. It is usually acute. System Administrator. This can occur on the palms and fingers in the hand and the soles of the feet. Hand eczema may be short-lived, however, in some people it. It can be acute, recurrent or chronic and is difficult to treat effectively. See the separate leaflet called Atopic Eczema for more details. Cold, harsh winter winds can dry out the skin and cause eczema flares. Discoid eczema, also known as nummular or discoid dermatitis, is a long-term (chronic) skin condition that causes skin to become itchy, swollen and cracked in circular or oval patches. All have slightly different symptoms. The main symptoms are dry, itchy skin that is red or darker than the surrounding skin. It can start in childhood as part of an in-built tendency to eczema, but is commonest in teenagers and adults. uk | +44 (0)020 7383 0266What is nickel allergy?. Crops of irritable deep-seated vesicles are followed by scaling and fissuring of the affected areas and may be complicated by Staphylococcus aureus. Emollients are moisturising treatments applied directly to the skin to soothe and hydrate it. This helps to prevent itch and reduces the frequency of eczema flare-ups. Lichen planus — may present in the mouth with painful erosive lesions (Whickman striae). Dyshidrosis. They help prevent patches of inflammation and flare-ups. Introduction. Advise of dermatologist first as infection control, then to aid the steroid to soak into the skin and protect my skin from things I touch. Emollients are often used to help manage dry, itchy or scaly skin conditions such as eczema, psoriasis and ichthyosis. Pompholyx (dyshidrotic eczema) is a type of eczema that causes tiny blisters to develop across the fingers, palms of the hands and sometimes the soles of the feet. I'd mention it to your rheumatologist next. doi: 10. Contact dermatitis: This form of eczema, also called allergic contact dermatitis, is brought on by environmental triggers. The most common site is the shins, but asteatotic eczema may occur elsewhere including upper limbs and trunk. It is often associated with hair follicle infections (folliculitis), boils and abscesses. Aj. Juvenile plantar dermatosis is rarely seen in adults. I get it between my fingers (and sometimes toes) every time there's a major temperature shift - so, spring and autumn. Symptoms. Arch Dermatol. It is a vesiculobullous disorder of the hands and soles. It is usually caused by seasonal changes, stress factors or allergens. N Engl J Med 2008;359:1718-1724 (3) Coenraads P. The word eczema comes from the Greek word “ekzein”, which means “to boil. Oral corticosteroids will have an immediate impact on the eczema and make them feel better, but they are for exceptional use and cannot be prescribed very often. Prepare warm bath water then add 1 or 2 cups of apple cider vinegar. I guess, if the immunosuppressants are not holding back one disease, there could well be a knock-on effect with the other. Pompholyx eczema is a condition in which small blisters develop on the hands and feet. “Dyshidrotic eczema can mimic contact dermatitis and even palmoplantar pustulosis, a type of psoriasis appearing on the hands and feet,” said Siegfried. It got its French name eczema craquelé from its cracked appearance. Eczema is a common inflammatory skin condition characterised histologically by spongiosis with varying degrees of acanthosis, and a superficial perivascular lymphohistiocytic infiltrate. Explain that eczema is a chronic illness characterized by flares, which can usually be controlled with appropriate treatment. The use of topical corticosteroids is not necessary while oral prednisolone is being used (although emollients should still be used). In the largest high-quality study of methotrexate for adults with severe eczema, 40 per cent (4 in 10) of patients saw at least a 50 per cent improvement in their eczema after 12 weeks of treatment. Dyshidrotic eczema, or pompholyx eczema, typically appears in adults under 40 years of age. One of the most annoying and possibly embarrassing areas to get eczema is the groin. Welcome to DermNet, the world's leading free dermatology resource. The remaining 15. It has a multifactorial aetiology but is rarely. Pompholyx: These present as deep-seated vesicles on the palms and rarely soles that tend to recur. DermNet NZ. Suggested by a painful wheal of 2–3. The term for this is ‘photosensitive eczema’. Faktor Risiko Pompholyx. A prescription antiperspirant that you apply to the area. Certain acidic foods can be harmful, also you'll avoid excessive hand-washing. [ 1] Herein we report a case of pompholyx involving the dorsum of the hands and feet with hemorrhagic bullae. It is a kind of skin eczema that is characterized by the occurrence of small itchy blisters on the hands and the feet. Hal ini juga senada dengan penjelasan dr. 15. Linear nigra - darkening of a vertical band of skin down the midline of the abdomen. Eczema - atopic is a chronic, itchy, inflammatory skin condition that affects people of all ages. Dyshidrotic eczema, also termed pompholyx, is a type of eczema (dermatitis). The prescribing guidance applies only to people with mild dry skin. Herpetic whitlow — this appears as either a single or a group of blisters. The Dyshidrotic Eczema Area and Severity Index was developed based on severity grades for the number of vesicles per square centimeter, erythema, desquamation, itch, and the extent of affected areas. Between 10 and 30 percent of kids get it. Pompholyx eczema. Typically, inflamed areas of dry skin tend to flare up from time to time and then tend to settle down. July 2014. It mainly affects the palms but can affect other parts of the hand, too. Eyelid eczema is common in adults with eczema elsewhere on the face. 21 ). Dyshidrosis (dyshidrotic eczema or pompholyx) is the term applied to a condition of recurring vesiculation of the palms, soles, and lateral aspects of the fingers in which hyperhidrosis is often associated. This type of eczema can lead to the formation of fluid-filled blisters. Difficult. Pompholyx is a vesicobullous disorder of the palms and soles. Prescribe generous amounts of emollients, and advise frequent and liberal use. Atopic eczema can be constant and severe for a minority of children. Pronunciation of pompholyx (dyshidrotic eczema) with 3 audio pronunciations. uk | +44 (0)020 7383 0266 ©2023 British Association of Dermatologists However, any areas of skin may be affected. Atopic eczema is one of the most common types and it usually. When the eczema settles, the skin may crack if it becomes over-dry, or break down if scratched or picked. Essentially, eczema is a dry, itchy rash, with scaling, rough patches or open, scratched areas of skin. Provide information on recognizing: The early or prodromal signs and symptoms of a flare. Cold, harsh winter winds can dry out the skin and cause eczema flares. It is common and can be localised to one area of your body such as your hands or armpits, or generalised, affecting the face and body. The symptoms usually last 2 to 3 weeks at a time. Moderate. Vitamin D and Vitamin B12 can also help improve common eczema symptoms. Certain drugs, chemicals and even plants can cause the skin to become sensitive to sunlight. The affected skin may be red and tender from time to time, and. rubbing. This was a prospective case-control study conducted between June 2001 and February 2004 at the University Hospital of Lome (Togo). Acute eczema (flares) varies in appearance, from poorly demarcated redness to fluid in the skin (vesicles), scaling, or crusting of the skin. My hands bubbled up in blisters which was very itchy. Irritant contact dermatitisDiscoid eczema symptoms. Acute palmoplantar eczema (more popularly known as dyshidrotic eczema or pompholyx) is an intensely pruritic, vesicular eruption affecting the palms, soles, or both [ 1,2 ]. Firstly any triggering cause, a contact material which leads to pompholyx eczema should be avoided. However, the clear fluid in the vesicles has a physiologic pH and contains protein, unlike sweat. It is a type of eczema that affects the hands and feet. Dribble and food can cause dermatitis around the mouth and chin. 1 A common form of eczema is dyshidrosis eczema, also known as pompholyx. the terms ‘pompholyx’ and ‘dyshidrotic eczema’ from January 2000 to April 2010. 03%. Types of eczema. Blistered and weepy skin. 2007;127:1568-1570 Pompholyx: a review of clinical features, differential diagnosis, and management. Pompholyx Pompholyx, also known as dyshidrotic or vesicular palmar eczema, refers to acute, chronic or relapsing blistering of the fingers, palms and/or soles. Faktor Risiko Pompholyx. Can be difficult to distinguish from. There are many types of fungal infections; for example, diaper rash, systemic candidiasis, candidal paronychia, body rash, and many others. Darker patches of skin in eczema (hyper-pigmentation) is caused by inflammation, which stimulates the melanocytes – the skin cells that give skin its colour – to increase melanin synthesis (the process of making skin pigment). 02 March 2011. With crawling, the extensor aspects of the elbows and wrists, knees and ankles are affected. Groin eczema, also known as groin. He is also highly rated in 21 other conditions, according to our data. Check if you have pompholyx. If I hadn't used the cotton glove. It’s estimated that 50% of pompholyx eczema cases take place in those with a familial or personal history of atopic eczema. Dry air and ointments can also trigger baby eczema. Most people can get good control of their eczema with these. So use less per application. The distinction between atopic eczema and other kinds of eczema occasionally presents a problem. Flexural eczema describes the location where an. Eczema herpeticum is a secondary viral infection usually caused by HSV (either type 1 or type 2) that concomitantly occurs with skin conditions like AD, psoriasis, eczema, irritant contact dermatitis, burns, and seborrheic dermatitis. Hand eczema is common and multifactorial. These usually pop up in clusters. Again this was only after the vesicles had burst and my skin was in the cracking/red raw stage. glycerin. 02 March 2011. It most often affects children who have eczema. In rare cases, eczema is directly caused by exposure to ultraviolet light (sunlight). Hand dermatitis. Hand Dermatitis. Dyshidrotic eczema (pompholyx) is a chronic, recurrent, often symmetric eruption of small, deep-seated, fluid-filled blisters on the palms of hands, fingers, and soles of the feet. Granuloma gluteale infantum. People should still be able to receive emollients on prescription for long-term skin conditions like eczema. Some years ago, I had a very serious attack of eczema on my hands and feet. Confusion can arise due to the way that eczema is classified, which is done partly using the most promi-nent clinical features (eg lichen simplex, pompholyx) and partly using the aetiology (eg atopic, contact irri-tant, contact allergic). Acute palmoplantar eczema is a type of chronic skin condition that can affect the palms of the hands and soles of the feet. Pompholyx (also called dyshidrotic eczema) is a type of eczema that affects the hands or feet. Pompholyx is a common eruption of small vesicles on the palms, soles, and/or lateral aspects of the fingers. Eczema, like most forms of arthritis other than OA, is an autoimmune disease so that's a connection. dust mites. Types of eczema. Eczema herpeticum is also known as Kaposi varicelliform eruption because it was initially described by Kaposi in 1887, who thought it resembled. The hands, face, neck, elbows, inside knees and torso are often affected in adults, while young children often develop eczema over their cheeks, ears, outer arms and thighs. I'd not actually heard of pompholyx but I see that it's a form of eczema. Case 32-2008 - A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae. Pompholyx eczema is a type of eczema that affects the hands and feet, with intensely itchy, watery blisters. If there’s anything you are unsure about, talk to your health visitor or GP, and there’s always the NES Helpline on 0800 448 0818. See Scenario: Mild eczema , Scenario: Moderate eczema, or Scenario: Severe eczema for management information. 2. This increase in synthesis results in pigment being transferred to the skin epidermis (the top layer of the skin). In other cases, no specific allergen can be identified but. You can see the border of the peeled region, with brighter red skin in the peeled region and duller/darker skin that is yet to peel. Kondisi ini berupa ruam lepuhan kecil berisi cairan yang muncul di telapak tangan hingga di sepanjang sisi jari. Pompholyx eczema is also known as dyshidrotic eczema. It usually starts as sore, itchy patches. Apply twice daily until symptoms resolve (stop treatment if eczema worsens or no response after 6 weeks). Dyshidrotic eczema, or pompholyx, causes small, itchy blisters on the soles, palms, and edges of the fingers and toes. Varicose eczema manifests as itchy, dry, flaky areas of skin. The palms and sides of the fingers (and sometimes the soles of the feet) then erupt into tiny itchy blisters that may weep (leak) fluid. Atopic dermatitis. See Scenario: Mild eczema , Scenario: Moderate eczema, or Scenario: Severe eczema for management information. Very difficult. The region is a warm, moist place, making it the perfect breeding ground for infections and rashes. In severe cases, the blisters may be quite large and may spread to the backs of the hands, feet and limbs. Eczema ( atopic dermatitis) is a long-term (chronic) skin disorder that involves scaly and itchy rashes. Diluted bleach bath: Adding a very small amount of bleach to your bathwater can help kill bacteria on your skin. This benign inflammatory condition is sometimes associated with psoriasis and is known as sebopsoriasis. A 3-year causative study of pompholyx in 120 patients. J invest dermatol. Eczema is a general name for a number of chronic, inflammatory skin conditions. MacConnachie AA, Smith CC. Pompholyx eczema. J invest dermatol. Short courses of oral steroids are the second line of treatment for acute flares, and other immunosuppressants have also been tried. The small, itchy blisters are the most noticeable sign of dyshidrotic eczema. Pompholyx (also called dyshidrotic eczema) is a type of eczema that affects the hands or feet. Symptoms. Repeated attacks may result in fissures and skin thickening. Itch is defined by a desire to scratch. Established treatments, both topical and systemic, are limited in efficacy, risk:benefit ratio and prevention of. The fastest and the safest way to get cured of Dyshidrotic Eczema symptoms permanently. Learn about its causes, treatment and management from this web page. Antiseptics are used to lower bacterial load. The blisters are often itchy. Venous eczema can form discrete patches or become confluent and circumferential. The two main treatments for eczema are emollients (moisturisers), used regularly, even when the skin is clear, and topical corticosteroids (creams and ointments) to treat flares of eczema. View pictures of dyshidrotic eczema in the gallery below. Psoriasis is at least moderately severe, as measured by the Physician's Global Assessment. “The only way to tell which is which is with a biopsy. This looks like tiny fluid-filled blisters. Introduction. However, the underlying etiology is unknown. Hyperhidrosis is the medical term for excessive sweating. 0% of patients. The goal is to treat the root cause of. Kondisi ini berupa ruam lepuhan kecil berisi cairan yang muncul di telapak tangan hingga di sepanjang sisi jari. This causes warm, red, itchy, and often swollen legs. Apply ample amount of lotions, creams or ointment to both hands. Cutaneous reactions to IVIg are generally minor. With a dermatologist’s help, many people discover what triggers their blisters. Pompholyx (called dyshidrosis by some) is a form of vesicobullous eczema that affects the palms and soles. Advise the person to: Keep their nails short — this avoids exacerbating onycholysis (detachment of the nail from the nail bed) and reduces the accumulation of material under the nail. Morphologic switch from psoriasiform to eczematous dermatitis after anti-IL-17 therapy: a case series. This means it may also be more difficult to see. Infantile seborrhoeic dermatitis (also known as ‘seborrhoeic eczema’) is a common skin condition seen in infants, which appears before the age of 3 months and usually resolves by 6-12 months. 1/2: If you have other children with eczema, asthma or hay fever or if both parents have eczema, asthma or hay fever. skin infections, including scabies. Paronychia. Dyshidrotic eczema or palmoplantar pompholyx has also been described as a rarer variant of such eczematous phenotypes. There are many types of fungal infections; for example, diaper rash, systemic candidiasis, candidal paronychia, body rash, and many others. Pompholyx eczema is a type of eczema usually confined to the hands and feet. Exfoliative keratolysis. Eczema often affects the face, and facial eczema can be particularly distressing because it is so visible. The vesicles are small (1–2mm), often symmetrical, with no associated erythema, and they do not occur elsewhere on the. With severe disease, the small blisters can merge to form. Lack of any serious side effects in any of our patients demonstrated that patch test is a non-invasive and remarkably safe diagnostic. Fixed drug eruption. The condition may be acute, intermittent, or chronic. Pompholyx comes from the Greek word for bubble. Eczema in babies can cause rashes on a baby’s skin, itchy skin and eczema flare-ups in the affected areas. There are several types of paste bandages available, such as icthopaste. 2007;143(12):1504-1508 (2) Dinulos JG, Zembovicz A. ”. Emollients. Hand dermatitis is also called hand eczema. 024) and nummular eczema (P =. The most common form of eczema is atopic dermatitis. An introduction to pompholyx eczema. There are different types of eczema, all of which can vary from mild to severe. The face is commonly affected in babies with atopic eczema. Atopic eczema: can affect the hands and may be dry/scaly or wet/weepy; Pompholyx: usually presents periodically with intensely itchy vesicles that predominate on the palms and sides of fingers. One patient with pompholyx developed an identical reaction, one patient with pompholyx developed noneczematous skin eruptions of increased severity (Baboon syndrome and a morbilliform rash), 17 one patient with no prior cutaneous reaction developed a new vesicular facial eruption, 20 and two patients with pompholyx or. This is to show that the peeling skin is not flaky, dry, or thin. The most common site is the shins, but asteatotic eczema may occur elsewhere including upper limbs and trunk. System Administrator. The most common symptom of discoid eczema is a patch of coin-shaped eczematous lesions on the body. [QxMD. Sekitar 50 persen penderita juga memiliki dermatitis atopik, atau riwayat keluarga dermatitis atopik. A variant of. Treatment should be continued for 48 hours after the flare. Eczema Treatment. There are two types of TCI, Protopic ointment (tacrolimus) for treating moderate to severe eczema, and Elidel cream (pimecrolimus) for mild to moderate eczema. The patient will get itchy. Case 32-2008 - A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae. There's no cure, but many children find their symptoms naturally improve as they get older. While the exact cause of eczema is unknown, it’s believed to be the result of a genetic defect with a subsequent interaction between the immune system and environmental allergens. Blood tests are not usually ordered; however, immunoglobulin E levels are commonly elevated. Pompholyx causes itchy blisters on the hands or feet that. It usually occurs on the hands and feet and has characteristic. For more information, see the CKS topics on Melanoma and pigmented lesions and Skin cancers - recognition and referral. Pompholyx eczema is a vesicular pattern of eczema affecting the skin of the hands and feet, often with a history of allergic contact dermatitis or fungal infection. Types of eczema 3 Atopic eczema 3 Seborrhoeic dermatitis 5 Contact dermatitis 6 Varicose/gravitational/stasis eczema 8 Discoid/nummular eczema 9 Pompholyx/dishydrotic eczema 9 Neurodermatitis (lichen simplex) 10 Eczema craquelé/azteatotic eczema 11 Quality of life 11 Diagnosis and history 12 Skin examination and clinical presentation of. Babies and eczema Baby with eczema Eczema is not unusual in babies, but there is a lot of conflicting advice out there. " Hormone changes that occur in pregnancy inevitably affect the skin. Atopic eczema is the most common form of eczema and tends to run in families. See morePompholyx eczema is a type of eczema that affects the hands and feet, with intensely itchy, watery blisters. It is also known as xerotic (dry) eczema. Pompholyx eczema is often observed in warm climates during summer and spring. 4 Patients with some features of AD, such as early-onset AD and head and neck AD, or large body surface area. Ear eczema can be an extremely irritating and, at times, painful condition. Diagnosis is based on characteristic. Other sites of the body may or may not be affected. 5. The condition is hard to treat because of the peculiarities of the affected skin, namely the. Last revised in October 2023. certain fabrics, such as wool and synthetics. Unlike contact dermatitis, which mainly affects the dorsal surface of the hands, this condition affects the volar and lateral. Dry, scaly, cracked patches. Groin eczema, also known as groin. Diluted bleach bath: Adding a very small amount of bleach to your bathwater can help kill bacteria on your skin. Earlier it was thought that, this skin disorder is caused by excessive sweating. Each affected nail fold is swollen and lifted off the nail plate. Pompholyx can sometimes be confused with similar-looking conditions. If your baby suffers from eczema, consult with a pediatric. Treatment will start for 30 seconds and build up to a maximum of around 15 minutes. The terms eczema and dermatitis are often used interchangeably to denote a polymorphic inflammatory reaction pattern involving the epidermis and dermis. Diffuse hereditary. Exfoliative keratolysis. It is sometimes called seborrhoeic eczema. Took a medication, including aspirin or birth control pills. Department of Dermatology and Allergology, Academic Teaching Hospital Dresden Friedrichstadt, Germany. Introduction. The blisters are often itchy. It is commonly seen in occupations involving wet work. Atopic hand dermatitis occurs in at least 50–60% of people with active atopic dermatitis, including children. In most cases, it can develop into itchy, watery blisters, mostly affecting the sides of the fingers, palms of the hands, and the soles of the feet. Beberapa faktor risiko yang dapat memicu seseorang memiliki kelainan pompholyx antara lain: Faktor genetik. Eczema can affect any area of skin, including the eyelids and around the eyes. The Dermatology Council for England. Nummular eczema may also develop as a reaction to some other types of eczema and their triggers, such as contact dermatitis and nickel. Barker J. Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for melanoma if they have a suspicious pigmented skin lesion with a weighted 7-point. Tinea pedis - commonly unilateral or asymmetrical erythema, scaling and pustules. The itchy, inflamed, dry, scaling skin of eyelid eczema is particularly. Crops of irritable. Atopic eczema is a dry skin condition that may be red, sore and dry. Strangely, this year it hasn't been too bad. If there’s anything you are unsure about, talk to your health visitor or GP, and there’s always the NES Helpline on 0800 448 0818. N Engl J Med 2008;359:1718-1724 (3) Coenraads P. Eczema herpeticum is an infection usually caused by the herpes simplex 1 virus or “oral herpes” – the virus that causes cold sores to appear around and inside the mouth. For this reason. Definition and nomenclature Pompholyx eczema is a very distinctive form of eczema, characterised initially by an eruption of very itchy vesicles on the sides of the fingers and palms of the hands and occasionally the soles of the feet and toes. This may be a sign of a type of eczema called dyshidrotic eczema — also called pompholyx or dyshidrosis. In severe cases, the lateral and dorsum of fingers can be involved. Eczema (also known as dermatitis) is a dry skin condition. It can be caused by stress, metal compounds, heat and sweating. 7%) and dry palmo-plantar eczema (32. Hyperhidrosis can be primary (no cause identified) or secondary (an underlying cause identified). Scenario: Assessment: Covers the assessment of the physical severity of atopic eczema as well as the psychological impact of atopic eczema. Hand care in healthcare workers. The most important step is to get a proper diagnosis. When it appears on the legs, it can be linked to poor blood. Darkening of the areola, nipple and genital skin. Consider prescribing a mild topical corticosteroid (such as hydrocortisone 1%) for areas of red skin. The word eczema comes from the Greek word “ekzein”, which means “to boil. It occurs slightly more frequent in boys than girls. weepy and painful. Increased sweat around your blisters. Dry skin tends to flare up and become inflamed into patches of eczema. Vesicular Hand Dermatitis. The recommended first-line (basic) treatments for most cases of eczema are emollients and topical steroids. Atopic eczema is an inflammation of the skin which tends to flare up. A 3-year causative study of pompholyx in 120 patients. Summary. Pompholyx (also called dyshidrotic eczema) is a type of eczema that affects the hands or feet. They may be prescribed as a treatment to use with topical steroids or as an. Apply ample amount of lotions, creams or ointment to both hands. Topical steroids — generally use an ointment if the skin is dry, and a cream if it is wet and weepy. ceramides. The distribution becomes flexural with walking, particularly involving the antecubital and popliteal fossae (elbow and knee creases). 4% palmar and 21. Use a mild, unscented hand cream several times a day. So, the main role of emollients is to prevent eczema from flaring up. Pengertian pompholyx (eksim dishidrotik) Pompholyx (eksim dishidrotik) adalah tipe eksim yang menyebabkan lepuhan kecil berisi cairan pada sisi jari-jari, telapak tangan dan telapak kaki. Hand eczema is common and multifactorial. 7%); and internal reactivation from drug, food, or haptenic (nickel) origin (6. 2007;143(12):1504-1508 (2) Dinulos JG, Zembovicz A. The blisters are often itchy. Seborrhoeic dermatitis of the eyelids tends to affect just the eyelid margins and is seen more frequently in adults. It accounts for 5-20% of the causes of DE [ 1 ]. Eczema. There are two sorts of steroid: corticosteroids that reduce inflammation, and anabolic steroids that increase muscle mass. The condition is hard to treat because of the peculiarities of the affected skin, namely the. Physiological changes of pregnancy. Gravitational eczema. Advise of dermatologist first as infection control, then to aid the steroid to soak into the skin and protect my skin from things I touch. This is to show that the peeling skin is not flaky, dry, or thin. Patients may be affected at any age, with women affected twice as often as men. Polymorphic light eruption (PMLE) is a seasonal, acquired, idiopathic photodermatosis occurring in spring and early summer. On white skin the patches look red or pink. It’s most common in people in their 20s, 30s, and 40s. If your baby suffers from eczema, consult with a pediatric. Eczema is a condition causing skin inflammation. It is also known as polymorphous light eruption, sun allergy, sun poisoning, prurigo aestivalis, summer eruption/prurigo, or eczema solare. Bilaterality was found in 75. It should be treated as soon as possible to avoid complications. The cornerstones of topical therapy are corticosteroids, although calcineurin inhibitors also seem to be effective, and another evolving treatment seems to be the intradermal injection of botulinum toxin.