weird rash - vesicles on hands and feet, bug-bite like on upper legs

[e23]

A few days ago I suddenly developed a rash on my upper legs and butt. It looks like small bug bites (red, slightly raised, round) of various sizes ( a few cm to 1/2 cm). They are for the most part not itchy.
Simultaneously I also developed a rash consisting of small vesicles on my hands and later feet. The vesicles are pin ***** sized with clear fluid inside. They are not itchy, but they slightly hurt (feeling of tightness) and if I pop them with a pin the ones on the feet become very itchy (not on hands though). There are about 6 on each hand and more on the feet. I think they multiply after I itch the ones on the feet. (The vesicles appear on the fingers, webbing of the thumbs, inner palm, sides and upper part of feet, toes.)

I had this same rash before, around the same time of year, 2 and 3 years ago. By the time I got an appointment the dermatologists didn't know what it was. I am 24, female, didn't have any unusual stress and didn't start using a new soap or anything. I also had a blood test a while ago (the dermatologist wondered if it was syphilis but it was negative). I don't have other symptoms and am otherwise healthy. In the past the rash would develop for a few days (rash on body spreads to arms and more of the legs, more vesicles on hands and feet) or a week and then go away as suddenly as it came.

[Bhupinder Kaur, MD]

Hello,
Your symptoms are clearly indicative of pompholyx. Wash the areas several times with fresh water. Do not use any cosmetic products at the sites. You can apply some calamine lotion at the rash as it will help in soothing the skin. You can take some OTC oral antihistamine medications like Benadryl or Claritin and see if it helps.

For mild-moderate symptoms a weak steroid may be used (e.g. hydrocortisone as dermacort), whilst more severe cases require a higher-potency steroid (e.g. clobetasol propionate, fluocinonide).But they are available under prescription and should be taken only after consulting a dermatologist. Symptoms  can be exacerbated by dryness of the skin. Use good quality moisturizers to prevent moisture loss from the skin.

If they prove unsucvessful, then Light treatment: UVA-1, PUVA, Grenz rays, Low Level Light Therapy using a Red + NIR (LED) combination can be used. For recalcitrant cases, corticosteroids combined with immunosuppressants may be used. In addition, you can apply aloe vera to the hands. It will help.

I hope it helps. Take care and regards.

[e23]

A week later, the blisters are gone and left no trace. The rash on the legs is also fading. Like last time, it appeared suddenly and disappeared suddenly. I checked pompholyx and the vesicles on my hand do not look like that, unless my case is just really really mild. Mine are tiny and don't cluster. Thanks for the feedback though!