Bumps On Fingers

[RandyAlan]

Help , I have a reoccuring problem with bumps appearing on my fingers .They are of various sizes from pinhead to pencil eraser and are various shapes. They seem to have very little fluid in them and are more of a solid nature. They occur on the sides of the fingers and tops of the front knuckle. They itch and burn and eventually either break open ,ooze and burn some more or the larger ones turn brown and hard and are able to eventually be peeled off. They have never occured on either pinky , either ring finger or thumb, so far only on the middle fingers and index fingers of both hands. This has been going on for several years now and I have tried many many creams ,quit biting my nails etc , yet the outbreaks continue and get worse each time. During one episode I had a bump on my right hand middle finger that extended almost into the bone . That area now has a deep skin indentation just as if the skin is there but the underlying tissue is gone. These outbreaks have no set pattern. My  nails are also dry and brittle and have little pits and odd flat spots in them. A doc friend thought I perhaps had a Herpes Virus in my fingers .He tried me on one of the Herpes drugs during one out break yet it seemed to do little for me. As I write this my right hand middle finger is all bumped up on the left side back to the middle knuckle. My left hand index finger had several tiny bumps on the top of the front knuckle . They have since opened and I now have a red burning fissure in their place. In my job I repair medical eqipment for a living , wheelchairs, scooters and a host of other related items. When these outbreaks occur it makes it very difficult for me to work as I need my hands to be fully functional. Lastly the skin has become thick on the fingers where the bumps occur. Help Please

[Alan Rockoff, MD]

This sounds like dyshidrotic eczema, a common and usually unimportant condition of unknown cause which produces bumps along the fingers that come and go.  If it is bothersome, topical steroid creams usually help, so you should see a dermatologist for diagnosis and proper therapy.  This sounds nothing at all like herpes.  Curing this is not possible--it always comes back when it wants to-- but there's no reason it should keep interfering with your work and daily life.

Take care.

Dr. Rockoff

[RandyAlan]

I forgot to also mention that I am an otherwise healthy 42 year old male. The outbreaks have not set pattern. I may not have one for a couple months or I may have one sooner. My current outbreak is pretty bad and has been ongoing for about two weeks. It seems that with each outbreak the bumps get worse, larger and more. They are sore to touch. I just hope to find some way of dealing with it . As I mentioned , I am a self biomed tech and in my off time is spent on Piano , Saxophone and Flute. All I do basically requires my hands.Many Thanks Again

[RandyAlan]

Oh, Doc perhaps though it may not matter I should mention I am a redhead with fair skin, not as fair as some but fair. I use latex free hypo allergenic gloves in my work , avoid many washing detergents, as well as many scents such as candles ,perfumes ,dust when possible etc. I do these things out of neccessity. I use to battle with follecuitis on my back and shoulders in the hot weather . It seems that eventually cleared up greatly at about the same time the bumps began on my figers though I doubt that the two are relative to one another. Thanks Again.

[Alan Rockoff, MD]

No change in my opinion.

Dr. Rockoff

[RandyAlan]

Many Thanks Doc I will get it checked out. The bumps theselves are not the problem but it is the pain that is assoicated with them. I have a high tolerance to pain but those bumps are so sore when they come that it is as if I have used a disk sander on my fingers. It odd to as to how they come on the sides of only the two fingers on each hand . I had them looked at one at the local ER but that was when I had the bad one on the right hand . They had concern for the finger as like I mentioned that one had basically destroyed the tissue beneath it very near to the bone. That tissue never came back. A surgeon friend of mine said it is the damdest thing he has ever seen. When he first saw my finger that time he to said wow things look bad for the finger . Luckily the er filled it with antibiotics no Penecillin though ( Unfortunately though a great medicine it tends to take my airway). The antibiotics helped heel the hole in the finger but the ER doc had little to offer on advice. They could not understand why it seems to always travel the same pathway each time. Again though many thanks I will make my way down to Washington and have one of the local DC dermatologists take a look at it . Thanks Again ,Randy

[Alan Rockoff, MD]

I don't really know how you can say that the bump is "down to the bone."  If you ever pick or squeeze the bumps, I strongly urge you not to while you're waiting to be seen.

Dr. Rockoff

[RandyAlan]

Sorry Doc ,that did sound a bit confusing. Actually that particular bump became very large and eventually opened and when it did their was a hole. Very similar to that of a skin ulcer pressure ulcer. My guess it maybe it had became infected but not sure if so ,how. I never pick or sqeeze any of them simply because they are not sore when they first arrive but usually after a couple days they are very sore even to touch. Again though many thanks.

ps  you may be onto something though with the eczema thought. I do have terrible skin . My scalp does more than flake ,patches of skin as large as a nickle lift up into my hair , nails are terrible and I have very dry skin. The skin on my fingers at times looks as if it has been in water for weeks, These things are not for lack of vitamins or creams as I use many of both. I would hate to see if I used none of them ( smiling) I would probably end up on the learning channel as the Man Whose Skin Fell Off.

Again Many Thanks

[RandyAlan]

In closing Dr. Rockoff I wanted to say thanks again. I just reviewed a website with photo's of Dyshidrotic Eczema and it looks very much the same as my outbreaks. I have over the course of having this problem been monitoring things that may cause it . In do so I have also notice that outbreaks tend to occur many times after my having performed certain work functions. I perform all types of Biomed work for disabled Veterans as I had mentioned. One service I perform though not everyday is the installation of electric scooter lift into Veterans vehicles. These of course are those crane type lifts that the user can hook their mobility device to when lifting it into the vehicle for transport. These lifts are generally made of steel and the powdered coated with paint . The hardware is generally nickle,steel or pot metal. I had mentioned to my wife once that it seems that when I install a number of these devices all within a week or so I the have an outbreak. As this equipment is new I retail it to the VA then install it for the Veteran. I wear no gloves to allow for better dexterity and finger manipulation as the equipment is new and not contaminated. Perhaps I will try some gloves though and see if that decreases my outbreaks .

ps. The wife agrees with you . She has been an RN now in the Schlero-therapy practice field for many years and she said it never did look like Herpes to her either.

Thanks Again.
Randy