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dry, scaly rash on palms of hands
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dry, scaly rash on palms of hands

for the past year or so i've had a dry, scaly rash on the palms of my hands, more on the right than the left.  the skin feels thick and leathery, and often cracks open into painfull fissures.  there has been a few very small blister-looking outbreaks on the edges of this rash, but this is rare.  the skin peels up in small, 2-3mm patches which i can pull off with my fingers.  the itch is often intense, with both hands turning red when scatched.  i've had one DX of fungus, (i am in the gym a lot) with a two month course of Lamisil, no improvement.  another DX of excema, with several months of Carmol and Protopic.  these helped somewhat with the scaling and itching, but only temporary relief- no more than just using vaseline.  the itching is the worst in the mornings, holding an ice cube seems the most effective at soothing it.  any help would be most appreciated.
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Fungus seemed unlikely, but when you added that two months of Lamisil didn't help, that rules out fungus altogether.  That leaves eczema.  Protopic is OK, but if it didn't help, I would suggest using one of the standard cortisone ointments, such as fluocinonide 0.05%.  If that doesn't help, its potency can be augmented by applying it overnight under rubber or plastic gloves.  Moisturizing ointments like Aquaphor (over-the-counter) also help.  I suggest discussing these options with a dermatologist.

Take care.

Dr. Rockoff
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