A Severe Case of Recalcitrant Pompholyx.

Background: Pompholyx is an inflammatory vesiculobullous skin disease of the hands and feet belonging to the spectrum of eczema.

Objective: To report a severe case of pompholyx, its clinical presentation, and its management.

Methods: A medical chart review was conducted on a patient with this condition.

Results: The patient was patch tested according to the North American Contact Dermatitis Group (NACDG) Standard Screening Series, and results were negative. In the past, she was treated with corticosteroid creams as well as narrow band ultraviolet B (UVB), and Psoralen ultraviolet A (PUVA) therapies, and none were beneficial. When the frequency of the episodes increased, methotrexate was introduced but failed to control the condition. Next, mycophenolate mofetil was started and gradually increased to 3.5 g daily along with a separate trial of radiotherapy with marked success.

Conclusion: Pompholyx can be challenging to manage, and treatment can involve an assortment of therapies over a prolonged period of time.