Dermatology Medical Photos User Group
severe skin problem - fingers - at a loss here
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Founded by Med Help on November 20, 2012
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severe skin problem - fingers - at a loss here

I am 55 and have a severe case ankylosing spondylitis, was diagnosed in 1992, which is an autoimmune disorder. I have had this problem on my fingers, mainly from the cuticles forward, though now it is spreading back further, for years. Years ago I went to a dermatologist and he said it was warts and after blistering my fingers, freezing them etc, they gave me aldara and it seemingly went away but that only lasted a few months.
I have went back a few times. 1st the practitioner told me my problem was picking and gave me a steroid cream, which while it did take away the redness, didn't help. I have had aldara cream a few times since but I go, she pretty much acts like it is me doing it and reschedules me for 6 months to see if it is better - it is not, it is only getting worse. It started on one or 2 fingers and is now on all of them and is getting very painful to where I have a hard time using my fingers to grasp things etc.
The problem - It started out as really dry skin, mainly around my nail areas and I did start picking it, so I am guilty there. It started to spread further down and up my fingers and the surface was really dry, cracking skin. I figured it was just super dry skin and was very surprised the dr 1st told me it was warts (no biopsy) as I did not see anything wart like and it appeared to be subcutaneous. When it spreads, the good skin on the edges of it will "peel" away from the bad, creating a deep fairly painful deep fissure
After this "fissure" is created, the bad then spreads to the fissure area it created.
Thinking (and it still may be) it was warts since that is what the dr said, I decided to try various wart remedies from potato skins, garlic, tea tree oil etc and then compound w.
When I use compound W or wrap the finger in duct tape, when it is removed the skin is almost an egg shell white, unlike other skin covered by the duct tape, and you can see small "nodules" below the skin.
Of course unfortunately I have no problem picking and had read where people just dig warts out, so I would use the duct tape and then dig these nodules out. The 2 "problems" there were even tho there were some bigger ones, basically the entire area was nothing but "nodules". The 2nd was these went really deep and pulling them out was pretty painful, but when I did get them out, I did feel a little relief, as though pressure was being relieved from the area. Not sure if nodule is the correct word after some time on google, but they are white masses, not really hard as they are living tissue, but a small mass, normally sort of conical shaped, attached to the tissue DEEP in my fingers.
But it just kept spreading finger to finger until all of them were this way. Yes I do pick them as I now try to remove the "nodules" for a bit of relief, but the main reason is if I do not do that, it seems to spread much faster so tho the reasoning is wrong, I figured it was the deep painful fissures it created (plus the pressure like sensation and seemingly super dry, sort of itchy feeling it creates) or suck up the pain and dig out as many as I could which at least seemed to keep it in that area.
Besides the obvious, another thing when I dig them out is how fast it all "regenerates". I could dig out a fairly large area (comparatively speaking since it is my fingers) and it would be a bloody mess (it bleeds profusely when I pull out the nodules) and a whole lot deeper then an average wound, but in just a few days it has completely "healed", looking as though I never did a thing. This is another reason, tho a bad one, why I started digging them out is because in a matter of 3 days or so you would never know I did it. If I don't do anything, it seems to spread much faster. If I dig them out, it can be extremely painful and a bloody mess, but it keeps it in that area longer as I guess it has to regenerate there before it spreads further. If I put my hands in water for any period of time, such as washing dishes, my car or worse, the swimming pool, those areas look like I had them wrapped in duct tape and are almost a bright white and just looks like nothing but dead skin - it is very, very ugly and I stay away from water if I am around others. I also do not like touching anyone, just in case it is contagious.
If I have had them wet for over say 10 minutes, it is very easy to pull out those nodule like things, but still painful when they come out.
It is now on all of my fingers with about 6 of them now going from a little behind the cuticle forward and now under my fingers on the fingertips.
On one finger that area is clear, but it isright on the 1st crease in my index finger so when I bend that finger it hurts. Oh, don't know if this is anything, normal or what - my fingernails look okay as far as color, tho one nail is deformed some, but it now seems to me that it is under my nails. I noticed the other day when I got out of the pool (good for my ankylosing spondylitis) that the weird white color was under the tips of my nails. I do keep my nails really short to keep me from picking at the dry skin on top and any loose skin that I always now have there, so there isn't really any gap under the nails and is all skin...which now sure seems like it is like the rest of the bad fingers. I will not pick at the nodules for a month and my fingers are itchy and bug the heck out of me, plus it spreads, and go to the dermatologist and (I see the practitioner now) she gives me aldara cream (3 times now) and tells me to come back in 6 months to see how it is doing. If I pull out the nodules etc say a week or so before I go to see her, she tells me my problem is I am picking and if I just leave it alone it will go away, then prescribes me a steroid cream and to come back in 6 months - it is always 6 months. I saw her at one apt and she gave me the steroid cream. 6 months later I went back and yes my fingers were not red and inflamed, but the cracking, nodules etc were the same. She told me how it was looking much better (because it was not inflamed from picking) and told me to come back in 6 months to see how it was doing. I asked her if I could dip my fingers in some water for a few minutes so she could see what they really look like, but she said there wasn't a need as if my fingers were doing fine.
I do know I probably exacerbate the problem by pulling out those white masses, but tho I am probably wrong, I sort of think that she may believe that since I did not respond to the one treatment (aldara) that it must be me and goes on that assumption. I have no doubt I do not help things, but you could wrap my hands in tape for 6 months and the problem will still be there, only probably worse by then (man that would be ugly when you took the tape off) I know I have a serious picking problem and need to stop it and have been working on it. It is just if I leave things alone, it just spreads so I end up digging them out.  I know I need to see another doctor, but was hoping maybe you have at least heard of something like this before. I treated it as psoriasis once but it did not seem to help, though it may have kept it from spreading but I stopped after about a month. Sorry so long but wanted to give as much info as possible and it is obviously bugging the heck out of me as it is going on about 5 years now and getting much worse now. I am even typing funny as my fingers hurt.I was just thinking the other day, if I had a choice between being crippled from my ankylosing spondylitis  and the excruciating pain that has brought me throughout the years or my fingers, I think I would take the ankylosing spondylitis. Unfortunately and seems par for the course, I have both.Oh, if medication makes a difference. The medications I have been taking since I have had this finger problem - morphine for about 15 years and tramadol. I had to pretty much stop nsaids as I was developing a bad stomach. I doubt morphine would do this, but who knows, I am sure at a loss.Thanks for ANY info
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