Rash on fingers with tiny dots

Hi,

I am a 26 year old white male, about a month and a half ago I noticed a dry patch on my left hand index finger.  I paid little attention to it until there was a similar patch on the thumb and on the right hand index finger.  

I bought some cream with 1% clotrimazole and began applying it twice daily for the last seven days.  During this time the rash seems to have continued to spread outward and I am now also noticing it on my left hand ring finger.

The rash presents somewhat circular, with the outer boundaries flaky, and the skin slightly raised.  The skin inside the boundaries is mostly dry and scaly, but not reddish.

Moreover - and this is the thing for which I haven't found any related conditions - there are tiny brownish dots scattered just outside the boundaries.  Each are about 1/4 of a millimeter.  As I watch the rash progress, it almost seems as if the dots determine where the rash will spread next.

My question is: should I continue applying the clotrimazole?  Or should I try an oral anti-fungal, or hydrocortisone, etc.?

[Alan Rockoff, MD]

You're describing hand eczema.  Clotrimazole is for fungal infections, and eczema isn't fungal.  You'll need a prescription-strength cortisone cream, because the skin of the hand is too think for over-the-counter hydrocortisone cream to do much. The tiny brownish dots are blisters, which are part of eczema.  One visit to a skin doctor should get you a specific diagnosis and proper treatment.

Take care.

Dr. Rockoff

[BryceL]

Thanks doctor!