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11-Year-Old Boy with Itchy Bumps on Sides of Fingers

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

An 11-year-old boy has had “itchy bumps” on the sides of his fingers for one week. The vesicles arose after the patient had been on a roller coaster.

Which of the following do you suspect?

Choose one to reveal diagnosis and discussion

Pompholyx
Tinea manuum
Scabies
Contact dermatitis

Answer: Pompholyx

See the full case at Consultant360

Pompholyx, which means bubble and is also known as dyshidrosis — is characterized by pruritic vesicles on the sides of the fingers and hands. Stress induced by fear of the roller coaster ride is thought to have precipitated this patient’s disorder. It is more common for a contact dermatitis to erupt on exposed areas (rather than the sides) of the fingers. Scabies is intensely pruritic and more widespread than the eruption in this patient, and it features few intact vesicles. Tinea manuum — a dermatophyte infection of the hand — generally develops more slowly than this patient’s rash, and is more scaly than vesicular.

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