I am a 25 yr old obese female, no diagnosed major diseases other than sleep apnea. More than 3 years ago, the skin on my right first and second fingers started to crack and peel. The skin is red and incredibly sensitive. It was winter at the time, I assumed it was ezcema (eczema) and tried to wait it out. Since that time, ALL of my fingers routinely have severe cracks along the inside of my fingers (worse on fingertips) and it's now on my palms. Most of the time I am unable to use my hands. Each finger may have several severe and deep cracks that take weeks to heal. I was seen in Mayo Clinic dermatology and we tried several steroids in several forms (ointment/creams), wet dressings. I have exhausted the retail world of lotions. I use derm gloves and I protect my hands. No matter what I do, it does not stop. It is a real problem for me as I am a single mom of a toddler (diaper material feels like a million hooks peeling my skin). I also like to cook and play guitar. It has gotten to the point that sometimes I cannot wipe myself, pull my pants up, or any simple movement. The skin is very hard and builds up a callous around the deep crevice and the skin will continue to split and come apart. If the area does not have a deep split in the skin... it is red and absent of outer layer of skin.
During a procedure for a bulging vertebral disk, I had a small amount of steroid injected into several facets. After this procedure, my fingers miraculously, disappeared. At this point I had been trying for about two years for some kind of relief. After discussing the possibility of a systemic affect of the local steroid injection, I consulted my dermatologist. She assured me that if the symptoms were a result of infection or fungus, it would have gotten much worse. At that time we did patch testing that revealed allergies to all metals. I wore derm gloves most of the time and I was told to continue topical steroid medications and avoid contact with any type of metal.
But still, no relief. I was never prescribed a systemic steroid due to the risks (treatments in some areas in Mayo Clinic are notoriously conservative).
This is now a quality of life issue. I am unable to use my fingers most of the time. I cannot grasp anything tightly as the skin will literally split open and the exposed skin covers a large area and it is painful and sensitive. I am unable to do MANY of the activities needed of the hands and fingers including leisure activities.
I am desperate for ideas as to what may be going on. Although it seems it is simply contact dermatitis, I am curious as to whether not the problem is a symptom. I have mild consistant elevated TPO antibodies and WBC (elevated neutrophils and leukocytes). I was checked for TPO antibodies when I had an episode of hives all over my body for over 6 weeks. I was told this was "normal" for someone with chronic hives (that was the first episode, it was considered chronic because of the length they stuck around).
I will note that at the time of the hives, I was on 4 seperate antihistamines for the hives, but I had no relief on my fingers/hands. The presentation has consistantly gotten worse, I am worried now because it is appearing on the inside of my wrist.
Any advice is appreciated. Please help me regain the use of my hands.
Going by the intensity of drying of finger tips and cracking it looks like atopic dermatitis to me. Cause is mostly allergic and treatment by a single line of treatment is difficult. Medical research shows that the most effective treatment plan involves using a combination of therapies to treat the skin and making lifestyle changes(prevention of triggers and application of lots of moisturizers) to control flare-ups. Doing so tends to increase effectiveness and reduce side effects from medications.
My sincere advice is to consult an allergist and get an evaluation done to confirm the allergens to which you may be allergic. Diagnosis of skin allergies includes Skin ***** tests (pricking the skin with a needle or pin containing a small amount of the allergen ('***** Testing' or 'Scratch Testing'), Patch tests (by applying a patch to the skin, where the patch contains the allergen.)And RAST.
Hope it helps. Take care and do keep me posted on how you are doing or if you have any additional queries. Warm regards.
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