How can pompholyx be managed?

Most attacks resolve spontaneously within 1 to 3 weeks. However, because pompholyx is generally symptomatic, certain measures should be tried. Hand protection, aluminum subacetate (Burow’s solution) soaks for debridement when oozing, and bland emollients help. Large blisters can be drained (and this rapidly relieves itching). Potent topical corticosteroids can be used with or without occlusion for moderate or severe acute disease. Soaking hands in warm water for 15 minutes before applying superpotent steroids and then applying white, cotton gloves overnight is especially helpful. Occasionally, oral or intramuscular corticosteroids are required to bring relief to patients. Oral methotrexate can be used in severe cases as a steroid-sparing agent. Keratolytics, tar, UVB light, or even PUVA can help chronic and/or hyperkeratotic disease.