skin lesions

Hi, I have a few persistant conditions.  I am unsure of the degree of relationtion between all these symptoms.

1.  I have had small fluid filled blisters between my toes and on the bottoms of my feet.  When they are popped the fluid coming out is clear, and they are slightly painful when healing however they have never been itchy.

2.  Recurring dry/flakey skin around both corners of my nose, sometimes at the corner of my mouth and once in a while on my ears.  When the small skin flakes come off it leaves red sensitvie skin underneath.  Over the counter cortrimazole cream seems to quickly make these things heal.

3.  Lately I have found that if I go a day without showering there is some small bad smelling, soft white clumps under my foreskin.  These can be easily washed off and there is no pain/itchiness/redness or discomfort.

Other than these things my skin is in very good condition, although I do sweat a lot.  I am very healthy, active and eat well.  I'm haven't been able to find anything seemingly matching my symptoms online.  Any diagnoses/treatment advise would be greatly appreciated.  

[Bhupinder Kaur, MD]

Hello,
The blisters on feet can be due to pompholyx and the red skin on nose sides can be due to seborrheic dermatitis. some triggers like allergic reaction to soaps, detergents, foods, latex, nickel etc may trigger the symptoms. Apply some calamine lotion on the affected area and keep the area well moisturized. Use only thin applications of moisturizer ointments as excessive amounts of ointment may restrict breathing of the skin and aggravate the condition.

Topical steroids can be applied but they are available under prescription. Moreover to prevent infection, topical antibiotics may be needed. I suggest you to consult a dermatologist and get it evaluated.

Seborrheic dermatitis causes flaky, dry, white to yellowish scales to form on oily areas esp under the nose or anywhere on face. People with seborrheic dermatitis produce too much sebum (the natural skin oil). Later, pityrosporum yeast grows excessively in the sebum.

Topical antifungals and mild steroids are the usual treatment and combination of the two can be used to treat stubborn patches. Oral antifungal drugs and immunomodulators such as tacrolimus and pimecrolimus are used in very severe cases. The other possibilities are of eczema or dermatitis.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.