Patients with pompholyx, or vesiculobullous dermatitis of the palms and soles, will typically present with small clear vesicles resembling grains of tapioca on the skin at the side of the fingers and the palms. The vesicles may be associated with intense itching and then become dry, scaly and fissured. The patient can be treated with topical and systemic corticosteroids. Typically, the practitioner will order a topical corticosteroid to ameliorate the flare and avoid pruritus. The patient should also avoid any skin irritants and wear cotton gloves when performing wet chores. Some patients have responded to PUVA therapy.