papular rash on hands

69y/o wm with overnight appearance of 1-2 mm blister like eruptions on both hands in a symmetrical pattern.  Lesions are clustered and tend to become confluent located along margins of hands primarily at thumbs and 5th fingers at junction of palmar  and dorsal surfaces. Some on palms at base of thumb. minimal medial and lateral wrist areas  Colorless.  Not painful.  No itch. Slight hypersensitivity to touch. Lesions have slowly progressed over 5 days. No breakdown. No allergic history.  Did have Photofrin injection April 3, 2000 prior to Laser Tx of Barrett's esophagus. Had 5-6 wks extreme skin photosensitivity which has now cleared. I think.   ?Dx ?Tx Any relationship to the photofrin? Prilosec 20mg daily only Rx. general health excellent.  

[Alan Rockoff, MD]

G.H.:

Your description certainly does not match that of any drug eruption.  It sounds more like dyshidrotic eczema, a common, annoying, and fairly trivial rash on the palms and soles.  I'd ignore it.  If the symptoms become very unpleasant, a dermatologist should see you for diagnosis and possible treatment with a steroid cream.

Best.

Dr. R