Recurring Rash (Contains Pics)

[clark7]

I've had this recurring rash for a while now, and I'm tired of playing the guessing game.  The length of symptoms can be anywhere from a week to 3 weeks, and I've noticed it is usually brought on by a trip to the shooting range (Sounds silly, but a gunpowder allergy?  or possibly a stress reaction?).  The way my healthcare works, I'd be lucky to get referred to a dermatologist soon enough for symptoms to be present for a diagnosis.

The pics are as follows:
1- what it looks like at first break out; 2 & 3- at full swing, pustules, between fingers; 4- if pustules are burst, this is what it looks like.   What I can't show, as it hasn't happened yet, eventually, they will dry out, causing dry, crusting, flaky skin (similar to any blister outcome).  As long as pustules aren't burst, I only suffer from intense itching,  but if pustules are broken, I get localized, intense, sometimes debilitating pain and burning.

I get this on my hands, between my fingers (the worst), and pretty bad on my eyes (exterior only, starts on the outer/inner corner of eye, eventually overtaking outer surface of upper and lower lids, causing swelling, and a stinging, sunburned sensation. This eventually will dry out, causing scaly, flaky eyelids, along with that burning sensation.

I've had some doctors (GP, Optometrist) make some opinions, but I won't offer those here, I want fresh perspectives.  Please help.

[Bhupinder Kaur, MD]

Hello,
Your symptoms are suggestive 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 still the symptoms do not improve then please get a clinical examination done by a dermatologist. 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.

[clark7]

Please view my profile for the other pictures.  The only one they let me post to the question doesn't really do it justice.

Thanks