A Solution for Dyshidrosis

Is soaking the feet in an aluminum salt solution an effective therapy for dyshidrosis?
-John Mosby, MD
  Corpus Christi, Tex
The first objective in the treatment of dyshidrosis is to establish the cause. A number of factors can cause or exacerbate dyshidrosiform eruptions on the hands and/or feet. Primary irritants, as well as contact dermatitis, can provoke a vesicular reaction. Ingested metals- such as nickel, chromium, and cobalt-may have a causative role. Fungal infections (particularly dermatophyte infections) and bacterial infections elsewhere in the body have been implicated. The role of stress has been difficult to determine; however, some patients believe that recurrences are associated with stressful life events. If the underlying causes of dyshidrosis are not addressed, no symptomatic treatment will be effective.
Astringent soaks still have a role during the acute phase in cases in which no obvious cause can be found.¹ Aluminum salt solution is available under the trade names Bluboro's, Domeboro's, and Burow's. Alternatively, a compounding pharmacy can make up a 10% solution of aluminum subacetate. Other astringents that can be used include Castellani paint (either clear or gentian violet) and potassium permanganate solution (1:8000 dilution); however, these are not as cosmetically acceptable.
-David L. Kaplan, MD
  Clinical Assistant Professor of Dermatology
  University of Kansas School of Medicine
  Kansas City
  University of Missouri Kansas City School of Medicine

References:

REFERENCE:

1.

Rook A, Wilkinson DS, Ebling FJG, et al. Textbook of Dermatology. Cambridge, Mass: Blackwell ScientificPublications; 1992:560.