rash, infection, warts or blisters on hands?

[Laura B.P.]

Help, My dermatologist has done three biopsies and sent me for a blood and urine analysis.  He claims he is baffled.  He has also tried numerous different topical treatments to no avail.

The backs of both of my hands have been breaking out in little wart-like blisters that when squeezed release a clear fluid.  They do not heal.  They occasionally get better but will reemmerge in a short time.  Also if I get a cut or scuff on my hand, it does not heal either.  My hands have become scarred and hideous looking.

The first biopsy came back highly suspicious but inconclusive.  He did a second biopsy and sent me for blood and urine work because he suspected Porphyria.  It was not Porphyria.  He has had me try creams and lotions for scabies and genital warts.

We are awaiting the results of the third biopsy.  His most recent thought is that it could be some type of viral infection, however the cream for genital warts is not working.

What could this possibly be?

[Alan Rockoff, MD]

Laura:

I am flattered that you think I can diagnose what is obviously a very strange and difficult, though not necessarily serious, condition.  Certainly porphyria is one possible diagnosis to consdier in a case like yours.  If the third biopsy is consistent with that diagnosis, then perhaps repeating the urine test might be useful.

One thing dermatologists often do if they are affiliated with major teaching centers is to share cases with academicians and colleagues at a "Grand Rounds" or "Staff Conference."  With the history and laboratory tests posted on the wall for reference, other dermatologists examine people like you for an hour or so, then sit down later to discuss their collective expereince and opinion.  If you were my patient and I were stumped, I would arrange to have you seen in this way, which gives you in effect dozens of (free) second opinions.

Perhaps after the next set of tests come back, you may want to discuss this or other avenues of obtaining additional opinions.

Good luck.

Dr. R

[Reginaldo Sitan]

I  wuld like to have an anwer about the red spot allover my body  it does not hurt or pain but get embares

[Tessa]

My finger next to my nail is green. I do bite my nails. What do I do?

[Rebecca Bull]

I had pimple things on my hands like you do that when squezzed produced a clear liquid. My doctor told me it was a dertmatitis called Pomphlyx.

[DENISE]

I have exactly what Laura described, but I have not been to see a doctor yet.  I have applied topical cortizone, which seems to help the little blisters heal, but does not stop the onset of new blisters/bumps.  What are the some of the other topical creams I can try.  Is this indeed a viral infection?  What exactly is Porphyria?

[jean]

I get these blisters on the palm of my hand(s) usually right hand, and fingers off & on. I have them now. I have notice in my case that I usually get them after working in the yard or with cleaning products around the house. oddly I have also notice that I get the blisters after working in the yard and when I put my jewelry on. The areas around my wrist (watch ) and ring fingers, I have also gotten these blisters on the botton of my feet and usually in the warmer weather when I wear sandles. It will itch and will sometimes get very infected. I have lived with this for years and have never found anything that will get rid of it but cortizone helps the itch. I wear other jewelry and have never had a problem with earrings or necklace.

[Cindy]

Yesterday, Friday, Apr. 14th I noticed a cluster of blisters right below my ring on my ring finger.  They stared itching and now the area has spread to my pinky finger on my first nuckle.  I woke up this morning to more itching.  Now I have swelling and itching in my first four fingers and the upper part of my hand.  The cluster of blisters are only in the two areas I mentioned.  Should I seek medical advise today (could this be serious) or get some over the counter benadryl?  I'm very hesitant about taking benadryl because that will probably make me drowsy and I have a 6 month old to care for.

[brian]

the person with blisters with clear fluid on the back of their hand could have Poison Oak/Poison Ivy. I had this on my legs for several months, and each time the blisters would burst and ooze clear liquid, new blisters would form shortly after.

[Marty]

Laura -- What you describe sounds a lot like what I was going through several years ago.  My skin was very fragile, especially on my hands and wrists and would seem to chunk off very easily leaving a raw spot that wouldn't scab over for a few days and then would take forever to heal.  I also had the liquid-filled bumps.  My dermatologist also suspected Porphyria but the test for it was negative.  The culprit in my case was Anaprox (I had been taking it long term for arthritis).  I discovered that one of the adverse effects listed on the product information sheet was "PCT" (Porphyria Cutanea Tarda).  I stopped taking the Anaprox and started noticing an improvement in my skin in about a week and a half, but it took several months for it to get back to normal.  I since have tried other NSAIDs for my arthritis and started getting the same reaction.  The only anti-inflammatory medication I have been able to take without having that hideous skin problem is Salsalate.

[belziebub]

A related discussion, Responding to blisters on hand was started.