Injured Finger

About 6 weeks ago, I sustained a laceration to the skin above the top joint of my middle finger.  The laceration was about half an inch and required 7 stitches.  Shortly after having the stitches removed, something that looks like a blister arose on my finger.  Today, I spoke to my (family-friend) doctor, and she confirmed that there was no infection.  I've been advised by others that the source of swelling (i.e., the cause of the blister looking thing) on my finger is either (i) newly established scar tissue; or (ii) the result in a newly formed blister.  Do these suggestions sound plausible in view of the foregoing?  Also, can I expect swelling to decline in the event this is scar tissue?

Best regards.  

[Alan Rockoff, MD]

As near as I can tell from your description, you have scar tissue that is likely to subside on its own over the next several weeks to months.  No specific additional treatment is needed.  If you have pain, increased swelling, or extension of what you see happening, you should show it to the doctor who put in the stitches.

Take care.

Dr. Rockoff

[bbally]

It appears the Flaking, peeling hand thread closed down to comments.

Please check in here so I know you are still watching.  The labs have come back.  I am correlating with the control samples this week.  So have definative treatment methods in three days.

Treatments are being applied to the Horse blood agar plates to see effectiveness on organism present.  Live treatment option is being used on my thumb, index finger is getting a different therapy.

Good news, most of this should be treatable with over the counter preparations.

Bad news, it is a combination of Fungus and bacteria that are causing the problem.

Good news is the combination explains why one therapy does not kill the whole problem off.

Anyway you three check in so I know you found a new live thread and I will start to post the therapies with the greatest kill ratio.  There is light at the end of the flaking tunnel.

[Bugbee]

I am sooooooooooooooooo excited to find you!!!  What you describe in the last thread has been a problem for me for about 10 years -- since I was 31 or so.  Nothing from any MD has helped.  Please give me a cure. I'll be eternally grateful!!  And, fyi, one of my dermatologists diagnosed my feet with "pits" as you asked about.  Is this related?  Either way, can it get better?  Not to make any of you nervous, but mine started on my right thumb and now after years of it, it's on both thumbs and both index fingers -- some mild indication that it wants to move to my right middle finger.  Nothing helps anymore.  Can't wait to find out if it can be helped.

[bbally]

Bugbee, get a tube of Lotrimin AFclotrimazole 1 percent.  Apply this four times daily and keep it wrapped with bandaids where possible.  We will be doing this for two weeks.

Yes pitted keratolysis is an important part of this.  My interest is in people who have had pitted Keratolysis and have developed what is often raferred to as Exfoliative Keratolysis on the palms or fingers.

Also where you ever treated with antibiotics for the pitted K?   Erythromycin?

I now have the confirmation from both labs that the same pathogen is showing up.

There will never be a large enough sample population here to create a scientific valid conclusion, but we may get enough people together to have one of the Dermatologist start to look at it on a large scale and see if this turns out to be a common cause.

Have new beef blood agar plates in my own lab now, going to scrape a few areas and see if my plates come out with the same organism.

FYI, it appears that the Corynebacterium, combines with Micrococcus are the main bacteria I fought with PK.  However like most I peeled this with my hands many times.  Others that did this have also developed the thumb, finger exfoliative keratolysis and can not shake it.  I orginally thought it was just PK jumping to the hand as is sited in the literature as a rare but possible jump.

I treated with full erythromycin and did see the pathogenic condition go away.  So this time I decided to have my family practioner cut the new stuff off.  On to see if it stopped the spread, to to have it cultured and get some answers.

It appears that when we treat the bacteria, we offer a chance for another pathogenic situation to occur.

Enter the plate reading all containing Candida Parapsilosis.  It is possible that when treating the bacteria factor a group of us then have the yeast go fungal on us.  And that is why we don't get relief with any one treatment.

Trying this topical antifungal first for 14 days.  If it goes away I will wait to see if I get reinfected.  If so my Doc will prescribe an oral AF to see if the yeast can be controlled that way.

So try the lotrimin with me if you want, but you have to report here so the Derm docs can start to talk about it.

[bbally]

Oh and one thing, this candida Parapsilosis is one of what I call the witch doctor conditions.  You will find a lot of **** about candida on the web.  Most of it is ****, check for peer reviewed papers.  You will know them as they usually charge about 20 bucks for them and have the volume and such listed as well as the review date and acceptance date.  The rest you need to be wary of, most is just hacks trying to sell mystical concoctions to those of us suffering without science answering the problem yet.  So watch, this candida comes up with a lot of voodoo snake oil sales whackjobs listing enough symptoms to make everyone suffer from the yeast beast.

[Bugbee]

[Bugbee]

Thank you.  I will get the Lotrimin AFclotrimazole 1 percent.  I work at a computer all day, and have small kids, so it will be very difficult to apply anything to my hands 4x/day.  I'll give it my best though-- I'd LOVE to get rid of this, or at least have some way to control it.  As for the "pits" on my feet, the derm simply cut out the calluses covering them to improve my comfort, and advised me on doing the same.  I've never had them treated with anything.  Btw, I'm not in the medical or scientific field -- what does "AF" mean?  Is it "anti-fungal"?  Regarding my feet, are you thinking that you'll have a recommendation for them as well?  

[Bugbee]

[Bugbee]

One important question that I forgot in my last post -- is this contagious?  Can I, for example, infect my children? Also, will it spread past my hands to, for example, my face?  

[bbally]

Can answer the spread question.  Reading the scietific literature it appears that normally a persons body keeps this stuff in check at a natural balance.  Something disurbs the balance the the pathogen goes nuts and becomes a problem.  But not much work has been done on DNA typing C. Parapsloysis to see if virulent strains exist.  I would guess it would not jump to someone else very easy.  But someone with immuno problems, it would have a chance.

It moved on me after two years on just the index finger.  I slipped with a knife and cut the index finger that was infected and created a puncture wound in my thumb at the knuckle.  This seem to get it embedded past the natural barriers that had been keeping it only on the index finger.

Anti Fungal.

If you still get pitts in the feet they are pretty easy to cure on your own.  Do they have malodor?  (stink funny)

[Bugbee]

No malodor, luckily. What do you suggest?

Question re the fingers:  have you determined that the cause of the peeling is entirely fungal or do you still suspect a virus as well?

[JRDMED]

I Have this stuff on both hands all over hands and fingers

[JRDMED]

Duh!  I meant fingers & palms.  I have had this problem for approximately 40 +/- years.  It is so bad sometimes my hands peel into the quick and crack open and bleed.  I have also noticed it gets worse when I mechanic on vechicles.  Also I have tried triple antibiotic ointments (OTC) and various types of lotions.  Lotions worsen it to various degrees depending on the brand of lotion.

[Bugbee]

Just starting my third day of having the Lotrimin AF on my fingers 4x/day.  It is very hard to work -- takes forever to type anything!  So far I don't see any improvement.  Anyone else?

[bbally]

Takes 14 days for the cell invasion to be completed.  I am on for five days now.  No improvement yet.  Doc says not to expect anything til near end of next week.

If this is a tough strain it could take an oral antifungal.  But plan is to attack with topical for two weeks.  If that does not clear, continue topical and add in oral antifungal.  Then reassess at that point.  I figure as long as I have lived with it, I can deal with no instant results as long as I kill it in the long run.

[Bugbee]

Did you say kill it?  You mean you think we can actually solve the problem entirely???

Where can I read about oral antifunals? I understand that the oral drugs used for nail fungus problems have can affect the kidneys.  What do you know about that, and can I learn more?

[Bugbee]

Have you changed locations?  You haven't been "on board" for quite awhile.  I'm still doing my AF 4x/day.

[bbally]

Still here working on it.  I am on day 8 of the AF treatment, index finger is 90 percent clear at this point.  Thumb is still getting flaked, but getting smaller and smaller.

I did start using Tough Stips Band Aid bandages to keep the topical in tighter contact with the skin.

Yes I think we can kill it off completely.

I am researching the interaction between bacteria and fungi to see what feeds what.  But so far decent results on the index finger, but staying the course for the full 14 days prior to deciding what is next.

I think it is working, took six days before mine index finger started looking like it was improving.  8 days it it is really starting to look good.

[Bugbee]

Mine is looking better too, although I'm not sure it isn't just running its normal course.  I've found small plastic finger covers to put over gauze.  They make it more comfortable to work.  

[klw6r]

Can I chime in here? I have not experienced the pitted K problem on my feet though so if your experiments are solely related to people with that issue too, let me know.

I am so excited to see all of your postings as I've had the peeling skin problem on my fingertips for a while now. I had a bout of it last summer and it disappeared only to come back this past June.

My left thumb tip is the worst with a long cycle of very tough, thick skin developing into an air bubble that then peels down to my knuckle. My left index finger also peels but does not develop the tough skin that my thumb does. I am left handed so it seemed like it could have been something that I am grasping with those fingers? Last month I had some very light peeling on other fingers too though it never hit my pinkies.

This has gone away before with antibiotics (though I can't remember which one at the moment). The most recent dermatologist I saw said it was fingertip ecxema and prescribed Fluocinonide and Bianfine but as of yet that has not been helping (about 14 days).

It is absolutely driving me NUTS. At one point I thought there might be a connection to Strep throat as I get it frequently and might be a carrier. Please keep me updated and thanks for all of your thoughts.

[bbally]

The Pitted K is not important to me, but I am interested in any data that may indicate you had other skin disorders.  Strickly for documentation purposes.

I am continuing with the Topical Fungal treatment program and have gotten relief.  But I am looking for a cure not a relief.  So I am still using the antifungal topically and am not starting an oral antifungal as well.

I have often wondered if it is viral as well.  The Biopsy I paid for clearly show C Parapsilosis as the active pathogen.  So I am continuing down the fungal track.

I did the Bacteria track first.

So far the data I have collected from hundreds of people clearly show that many skin disorders produce the same symptoms.  So it may be a question of biospy more often and less guessing.  But again still to early on the data set to even begin to conclude anything.

I will keep posting here and if this thread closes I will jump to another unused, Doc Answered thread so we can all see what the latest is on the problem.

[klw6r]

Thanks for your response. I have not had any other diagnosable skin disorders. I vaguely remember as a kid my feet would sometimes peel but I never went the derm for it and I can confirm w/ my mom. This is hardly of note, but the only other unusual skin issue I have is its histamine reaction to any hard scratches; if I scratch an itch on my neck, my nail mark will turn bright red for a while. Weird but probably not related.

I spared the details on my fingers symptoms because they were so similar to what was written above but if you need any more information let me know. I will continue to read  your entries so thanks for keeping them updated.

I would love to find a cure to this too as I am so frustrated that the docs seem to dismiss it. Just yesterday an air bubble formed on my right thumb tip and proceeded to peel. I just don't understand why I would have that "elmer's glue"/thick skin feeling on my left thumb where it is noticeably worse (thick skin and somewhat scaly too)and only a few other fingers just peel slightly....and why it would come back months after it disappears with an antibiotic??

At this point, per other reasons I am trying to treat it w/ topically and not w/ oral medications (or else I would have asked for another antibiotic).

Before I end, just a few ignorant questions: how is a biopsy different from a scraping? Are you referring to having a doc take off just a piece of the skin that is peeling and examining that? Also, who does that, a dermatologist? Do you ask for any specific tests or to test for specific things while getting the biopsy done?

If I ditch the adrenocorticosteroid cream (which I don't think I've noticed any help from), and try the topical antifungal, I worry about being able to keep each of the three (for now) peeling fingers wrapped well...or should I just apply it to to the main issue of my left thumb?
THANK YOU!

[Bugbee]

bbally --  Question:  I did the AF for a week with excellent response, but then got called away 5 days of 24/7 at work, and was unable to apply the AF.  I see some residual peeling.  Would it do any good to start the AF again now?  And if so for how many more days -- do another 2 weeks? or should I wait until the next episode -- which will be within a few weeks I'm certain.  

klw6r -- As to the question of keeping the fingers wrapped, here's what I do:  apply the AF, cover it with a thin gauze, then use little rubber finger covers (from Wal-Mart).  Sometimes I wear gloves too but they're really hard to get on over the finger covers.  Although people stare at me I can use my hands much better with the finger covers than I can if I cover the gauze with band-aids --- and importantly the finger covers are reuseable if they don't rip which saves some money in this costly experiment.

Speaking of cost ---- THANK YOU VERY MUCH, BBALLY, FOR ALL YOU HAVE GIVEN IN BOTH TIME AND MONEY THROUGH WHICH MANY MANY OF US ARE GOING TO BENEFIT.  IF I CAN MAKE A FINANCIAL DONATION TO YOUR WORK, OR A CHARITY OF YOUR CHOOSING, PLEASE LET ME KNOW.

[klw6r]

I second that offer for sure!

I am going to start w/ Lamisil (which I have, though should I buy Lotramin instead?).
Please keep us updated!
-kw
ps does anyone else have trouble with this website? I tried to find the beginning of this thread on the other topic and I couldn't find it. I also had trouble finding this one on a different computer.
pss I looked up some pics of Pitted K on google and I might have had it very mildly as a teenager.

[bbally]

No donation required.  I just want to kill it.  I would guess that you should start the 14 day process all over.  But again we are experimenting so if you want to wait go ahead and do so, just report the results so we can document it.

I look forward to the report on lamisil, as it is an excellent antifungal and should kill it.

I am thinking of adding a 7 day course of oral antifungal meds.  I will report back here as usual, and if the thread closes, just look for my bbally on one of the other threads after the Doc is done with it.

[Bugbee]

Saw my doctor today and he suggested I do lamisil instead of lotramin.  Interesting timing considering yesterday's post by klw6r.  Bbally:  What is your suggestion for eradicating the Pitted K?

[klw6r]

I just wanted to give a quick update after 7 days of lamisil: I think it is working, but not totally cleared yet. Still a little peel on about the first half inch from my thumb tip to the middle of the skin to first knuckle. Still the "waxy"/tough skin feeling at the fingertip (and a little below) but I think it has receded and is in a smaller area (I hope).

In the meantime, a few of my other fingers have started to peel, but the peeling on the other fingers is much lighter and does not produce the waxy feeling of the thumb. It is very superficial peeling and doesn't produce tender skin underneath.

I'm ignoring the other fingers at the moment, but I'm hoping they won't re-infect the thumb (and keeping fingers crossed that in another 7 days it will be totally cleared!).

what a pain - thanks again for the antifungal medication suggestion. I will update again after 14 days and be interested in what oral antifungal you used if you decided to go ahead with one.

[Bugbee]

Drats!!!!  I quit the antifungal early and IMMEDIATELY got the waxy finger thing back.  Here I go again.  

Bbally:  Do you have an opinion about whether it's at all helpful to use the AF like a hand lotion several times a day instead of coating the peeling areas and covering with bandages?  This is what my internist suggested and it is much much easier.

[klw6r]

for what it's worth, that's what I've been doing with the other fingers, albeit not that religiously (and hence, for whatever reason, it doesn't seem to be clearing it up). I am dying to get this cured!

[klw6r]

I wonder what happened to bbally? I know this website is a little weird and the search doesn't work well.

I just wanted to update you guys on the 14 day treatment of lamisil.  I am really happy that it is 95% better!  I say 95% and not 100% because of a couple things: most of the waxy/tougher skin feeling is gone, but not all. My left thumb still feels slightly different than my right thumb when I run a fingernail over it. All the flaking has disappeared which is great, though there are a few very slightly peel-y areas where the skin hasn't completely fused together.

I had started to rub lamisil on all my fingers a few times a day (not covered except for my thumb) and I think I will continue to do as they are still slightly peeling (very slightly - not noticeable to anyone but me). The only thing I worry about is my other fingers re-infecting the thumb, or the thumb not being 100% normal and going down hill. I will wait and see.

Bbally, I'd be really interested to see how the oral antifungal worked. I do think that unless it was a coincidence, my issue was also fungal related since the treatment seemed to improve my thumb a lot.

I wonder if there is another website we could migrate to that has more formal discussion areas where we could get e-mail alerts if there is a new post or something like that -  I'm really interested in getting continuous updates from you guys to get rid of this thing for good (and also wondering if this will flair up again in the future)!
Thanks!

[Bugbee]

I agree.  Let me know what site you want to switch to.

Bbally, where are you?

[klw6r]

oops see this is what happens when I don't get e-mail alerts - I forget! Let me investigate and see if I see any good sites. let me know if you have any ideas.
Meanwhile I'm thinking I will start on the antifungal again just rubbing it in like a hand cream. Waxy feeling slightly returning on my thumb :(.

[n2medhelp]

A related discussion, BBaly, are you still posting any results from your study was started.