No matter how long you’ve been living with lupus, you’re likely surprised when new symptoms arrive. For some MyLupusTeam members, that means dealing with dyshidrotic eczema — a rash that can cause small blisters or bubbles to form on their hands and feet.

Dyshidrotic eczema — also known as pompholyx, foot-and-hand eczema, and palmoplantar eczema — can lead to itching, peeling, burning, and a rash where the blisters form. Because this type of rash isn’t among the common lupus skin symptoms, some people are confused when it occurs.

“A bumpy, itchy rash comes and goes on my hands due to stress or extreme fatigue, but it’s almost constant on my feet,” one member wrote.

“Many people here get this,” another member said. “The sun triggers it for some, contact allergies or stress trigger it for others. Google ‘pompholyx,’ also known as ‘dyshidrotic eczema.’”

If you’re living with rashes on your hands or feet, you may wonder if they’re related to lupus. Here, we explore whether there’s a connection between the two conditions and discuss what you can do about dyshidrotic eczema.

What Is Dyshidrotic Eczema?

Dyshidrotic eczema typically starts with a few small blisters on the hands or feet. These small blisters may combine to form large blisters that look like hives. These are called lesions, and they can be irritating, painful, and itchy. They usually last for two or three weeks. After the itchy blisters clear up, some people never have a dyshidrotic eczema flare again. Meanwhile, others may see their symptoms come and go for years.

What Causes Dyshidrotic Eczema?

Dyshidrotic eczema isn’t completely understood. It’s believed to be a chronic inflammatory condition with many possible triggers. It doesn’t affect your lifespan, but it can interfere with your quality of life.

If you have dyshidrotic eczema, your dermatology provider will likely recommend skin care tips to help restore your skin barrier and manage your symptoms. They may also recommend topical (applied directly to the skin) corticosteroids or oral (by mouth) antihistamines to manage itch and inflammation. In severe cases, your doctor may prescribe an oral corticosteroid or immunosuppressant (drug that suppresses immune responses) to help ease your symptoms.

What’s the Link With Lupus?

If you have both eczema and lupus, it’s natural to wonder: Does lupus cause eczema? However, dyshidrotic eczema is not considered a symptom of lupus. Research is limited as to why this skin condition flares up in people with lupus. However, some lupus triggers overlap with dyshidrotic eczema triggers.

Heat and Sun Exposure

People with lupus often experience skin sensitivity, which can get worse when facing certain triggers, like sun exposure and high temperatures. For a lot of people with lupus, the heat can trigger serious and painful flares.

Dyshidrotic eczema can also be triggered by high temperatures and sweating. People with overactive sweat glands and those who spend a lot of time in the heat are more likely to develop this type of eczema.

Even if lupus isn’t the direct cause of your eczema symptoms, both conditions may flare up at the same time in warmer temperatures. If this is the case for you, try to avoid being in the heat. If you need to go outside when it’s hot, avoid overheating by using a portable or hand-held fan, wearing a cooling vest or a hat, or carrying an umbrella.

Stress

For many people with lupus, stress can trigger symptoms and occur before flares. “Stress is the major cause of my flares,” one MyLupusTeam member wrote. “But it’s hard to stop stressing when I’m feeling awful.”

Stress is also a known trigger for dyshidrotic eczema. People who get frequent pompholyx skin rashes may be advised to try stress-reduction techniques to keep symptoms from coming back.

Stress management is an important part of living with lupus. Some providers suggest using mindfulness meditation to help ease lupus symptoms. If you’re able to shed some of the obvious stresses in your life, you may find that the symptoms of both conditions get better.

Environmental Factors

Both lupus and dyshidrotic eczema can flare due to triggers found in your environment. Triggers may differ from one person to the next, but they can be due to certain irritants or allergens. Symptoms may flare because of a soap or detergent, a type of metal, seasonal allergies, or cigarette smoke, among other triggers.

If you aren’t sure what causes your lupus or your skin symptoms to flare, it’s a good idea to keep a symptom journal. Write down what you ate, where you were, and what you most recently did prior to a flare of either condition. Then you can work with your healthcare provider to narrow down what may be triggering your symptoms and get medical advice to help address any issues you identify together.

Talk With Your Doctor About Skin Rashes With Lupus

If you’re experiencing a new skin rash, your primary care or rheumatology provider can refer you to a dermatologist for a skin evaluation.

Because lupus is an autoimmune disease that commonly affects the skin, you may develop different skin rashes, including:

• Discoid lupus — Scaly, raised sores that often appear in a disc shape on the face or scalp and can cause scarring and hair loss
• Subacute cutaneous lupus — Scaly, discolored patches or circular sores that often develop on the torso (back and chest) and arms, sometimes as a side effect of certain drugs, such as acid reflux medications
• Acute cutaneous lupus — Raised, discolored rash that can appear over one part of the body, such as the face (butterfly or malar rash), or over larger areas
• Nonspecific skin inflammation — Rash or inflammation not specific to lupus that may be linked to other autoimmune conditions, such as hives and swelling

In rare cases, people with lupus can develop bullous systemic lupus erythematosus (BSLE). BSLE is another skin condition that causes blistering and can be misdiagnosed as other skin diseases.

To diagnose your skin condition, your dermatologist will look at your skin and may perform a biopsy. Based on your diagnosis, your doctor may prescribe oral or topical steroids or immunosuppressants to calm your immune system and manage your symptoms. They may also recommend antimalarial pills to help protect your skin. Work with your doctor to find the best treatment option for your rash that will help improve your quality of life.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you experienced dyshidrotic eczema symptoms while living with lupus? What tips do you have for avoiding or addressing symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.