Pomphlyx and paronychia

[smbishop]

Hello, I am desperate for some help on this matter. I have seen countless GPs and a dermotologist and none of them have been able to help.

My fingers vary between being dry and cracked - to bumpy blisters with pus. My nails are deformed, raised and have separated from the nail bed. There is no cuticle. And, of course, it all itches like hell. It's being going on for the past three years.

I have been commited to all the usual advice that I have found (keep hands dry, etc). I have persevered with all the creams and ointments that have been prescribed. Nothing has worked.

The Dr's that I have seen just appear to 'have a go' with whatever cream they fancy. One Dr even said 'do you chew your fingers? No? Well I don't know then'.

For all the websites that I have found that tell me my symptoms are common - I wonder why it has never been diagnosed properly on any of my many many trips to the GP. The dermo I saw prescribed an ointment - which was useless as it was far to greasy to be effective on my hands. I feel like giving up.

This problem needless to say is making my life a misery and I am getting very depressed.

Please can someone offer me advice on what to ask my Dr for or what I should tell them? Or advice on products..

Any feedback would be much appreciated.

Thnak you for reading.

[Johnrimer]

I would ask your Dermatologist about a medication called Raptiva. It sounds like you have Psoriasis from what you wrote. I have been living with Psoriasis for over 10 years. My nails are the same way. I get blisters on my hands as well.

What Raptiva is:

A weekly injection you will give yourself once a week to slow down your immune system. It will fix your nails and skin problems you have. I have been on it for 2 years now.

[JimTut]

The Pomphlyx appeared on the right foot (ball of foot). It the spread thereon, then left foot , and hands. GP suggested Lotrimin applications.
Not very suggsesfull, however.
Tried soaking feet in Epson Salt water. No help.
No water in blisters. I peel off dead blister skin.
Any suggestons?
PS I'm male 77 years old in good health.

[smbishop]

Thank you for the reponse. I know that I have eczema, that the cause is unknown and that soaks/solutions can help the blisters.

I have severe pompholyx around the nail folds which has caused nail dysrophy. Steriod creams have not worked. Is there any treatment that helps the nails to recover? i.e. cuticle return, lessesning of swelling etc.

Thank you.

[Dr_Aparna]

Hi,
This seems to be eczema which has affected your hands. Pompholyx is a common type of eczema affecting the hands. It is also known as dyshidrotic eczema or vesicular eczema of the hands.

Initially it presents as tiny blisters (vesicles) deep in the skin of the palms, fingers. The blisters are often intensely itchy or have a burning feeling. In severe cases, big blisters and cracks develop which can prevent work.

In the later stages more peeling, cracking, or crusting can be seen. Then the skin heals up, or the blistering may start again. One site may be blistering, while another is dry and cracked.
Severe pompholyx around the nail folds may cause nail dystrophy, resulting in irregular ridges and chronic paronychia (nail fold swelling).

The exact cause is not known. Some suggest that it could be caused by abnormal sweating. It gets aggravated by contact with irritants such as water, detergents and solvents. Contact with them must be avoided as much as possible and protective gloves worn to prevent additional irritant contact dermatitis.

Soaks or compresses using weak solutions of Condy's crystals (potassium permanganate) or vinegar in water are applied for 15 minutes four times a day. This will dry up blisters. Hand creams like dimeticone barrier cream, should be applied liberally and frequently to keep the skin soft.
Steroid creams are indicated when the skin is blistered or weeping. PUVA therapy can be useful in selected cases. This is a special kind of ultraviolet (UV) treatment.

ref:http://dermnetnz.org/dermatitis/pompholyx.html