How is vesicular palmoplantar eczema diagnosed?

Updated: Aug 23, 2019
  • Author: Jessica Dunkley, MD, MHSc, CCFP; Chief Editor: Dirk M Elston, MD  more...
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The diagnosis of palmoplantar eczema is essentially a clinical one; however, studies may be helpful in excluding other disorders. Consider the following:

  • KOH staining of skin scrapings to rule out fungal infection, especially in hyperkeratotic forms of the disease

  • Swab and culture of suspected lesions to exclude secondary bacterial infection if infection is suspected

  • A biopsy to distinguish eczema from psoriasis or some forms of palmoplantar hyperkeratoses

  • Patch testing to exclude contact dermatitis or a systemic reaction to contact allergen

  • Allergy testing may suggest an atopic tendency

There are no laboratory studies specific to vesicular palmoplantar eczema. However, IgE levels may be elevated in patients with atopic dermatitis. [2]

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