Blisters on hands and fee...

A 27-year-old man attends your clinic with a 3-day history of a severe burning itch over his hands associated with localized blistering and similar although less severe changes on his feet. He is otherwise well, although he did suffer from asthma is childhood and occasionally still experiences hay fever. He is not on any medication. He works as a graphic designer and his hobbies include cycling and football, he has no exposure to allergens or irritants. He is unaware of any triggering factor. 

Examination 

He has diffuse vesicles, coalescing to form tense bullae over the palmar aspects of both hands extending into the interdigital spaces and onto the dorsa of his fingers and hand. In addition, he has erythema, maceration, fissuring and peeling between the 4th and 5th toes on the left side and bilateral but asymmetrical (left worse than right) purulent vesicles over the insteps.