What you are describing seems like an dyshidrotic eczema, as already confirmed. The site for this kind of eczema is palms, usually there is itching or pain, but a small percentage of patients might not have any symptoms at all (as in your case). This type of eczema is seem more in patients with stress, family history of atopy, exposure to cobalt over years, exposure other contact irritants, recurrent immunoglobulin therapy etc. Rarely, no particular cause is found. Most of the patients respond to steroids. But other treatments might be needed in recurrent cases -
- oral corurse of antibiotics for staph infection
- oral steroids alongwith steroid cream used
- topical calcineurin inhibitors may be helpful like topical tacrolimus or pimecrolimus. If patient responds to these then steroids might not be needed.
- potassium permanganate soak
- UV-A or UV-A1 alone or with oral or topical psoralen
- botulinom toxin injection.
If you are not responding to steroids, then you need to discuss the above tratment modalities with your Dermatologist for further benefit.