Vesicular rash (hands) and can heat cause petichiae?

[cb1980]

These are really 2 separate questions, but I think 1 can be answered quite quickly - so I'll start with that one.
Some probably relevant medical info: post viral cfids (8 yrs), Hashimoto (3 yrs), 28 y/o female.
No known allergies.

1>
Can heat (1 hour in the sun) cause petichiae or should I start to get worried about this?
(Picture: foot on the right).
No itching, don't disappear with pressure.

2>
The more complicated one. Talked to 3 docs about this, and got 3 different diagnoses.
It doesn't bother me enough to start messing around with creams, but I do really like to know the cause, and of course, what it is..)
(Picture: hand on the left).
I've got some kind of vesicular/eczema kind of rash on my hands off and on (more on) for the last two years.
It started on my left hand, and now is on my right hand too, mainly index/middle fingers. No where else.
I am right handed, so a contact allergy seems unlikely (or it would have started on my right hand?)

Location is at the knuckles, and where my fingers bend, but at the moment all along my right index finger on the side closest to the thumb too.

It starts as a blister like thing, with a reddish/brownish tiny dot inside.
Size varies, can be really small as in the picture, or a whole hoard of bumps that seem to merge (whole side of my finger).
When it's in the blister stage it hurts a little, and quite a bit when I bump into the wall or something.
Then it dries out (I think this takes about a week, maybe a little longer) and then there's just a reddish mark left that will slowly fade (takes weeks/months). When it's dry it itches for a while, but it does NOT flake.
Regular hand cream helps a lot.

One doc said "dyshidrotic eczema" - probably related to thyroid problem or cfis (safe bet ;) ), other doc "not dyshidrotic, not sure what" third doc "er...?no idea..does it bother you, we can try steroid cream".

So.. any thoughts please?

[cb1980]

Thank you!

Hands: they're really clearing up at the moment.
I'm a bit hesitant to actually go see a doc/derm for this (traveling doesn't always go that well..) since it's not contagious, and I doubt (s)he can actually prevent it?
And for just treating it.. my regular handcream (Lush) seems to work OK, very greasy stuff ;)

The foot - I thought any pin-***** rash that will not disappear if you roll a glass over it is classified as petichiae?

I don't think this is relevant info, but to be complete:
I was born very prematurely (3 months), and have had meningitis as a baby (though not the petichiae version, and I know this is not meningitis now ;) ).
Quite healthy and active until I was 20, I actually was in my second year of med school when I got sick (post viral cfids). Never had any eczema ever before now.

I noticed the dots on my feet (left foot worse than right!) in the late afternoon 3 days ago.
The only thing I could think of that might have caused it was me sitting in the sun for 1 hour with bare feet in flipflops in partial sun/shade mid-afternoon.
Have stayed out of the sun with my feet since, and they're almost gone now.
This is underneath the skin, pinprick red/brown dots.
Regular heat rash is raised and bumpy and blotchy/reddish - somewhat itchy/burning, and more on top of the skin - right?

My hands and feet are (and have always been) quite cold by the way, even now with great summer weather.

[Vanessa Lacuesta]

Hi,

Thanks for elaborating on your condition.

With regards to the foot, you have referred to the petechiae as a heat rash because the feet are usually covered thus making them warmer?

If this is the case, then the rash may be due to a contact dermatitis .Dermatitis is usually itchy but not necessarily weepy or excoriated.

For the hand condition, I do agree with dishydrotic eczematous disease. It may be something you want to ask a dermatologist. It appears that both the hand and feet conditions may be eczematous in origin.

[cb1980]

Thank you very much Vanessa!

I see my picture is not approved yet.

Feet:
The strange thing with the foot heat-rash is that my feet were in more shade then the rest of me, and the petichiae only appeared on my feet. (26 Celsius and a little wind, not *that* hot).
I guess either sunblock or socks will work.

I do think the thyroid levels are OK and have been so for well over a year.
Test results from 10 months ago and 4 months ago were similar (and perfect), meds last adjusted about 2 years ago. I'm taking both T4 and T3.
Can't really tell from fatigue if the levels are off (didn't notice being hypo either due to the cfids, but had a high antiTPO). My weight only changed the month before the Hashimoto was found out (actually *lost* weight then - to the point my doc thought I was anorexic, and I thought his scales were broken...Now back to my normal BMI of somewhere between 19 and 20)

Hands:
Blister fluid is more clear than yellow, definitely not brown.
The rest seems to fit except there's no flakyness once it's dry (more callous like) and the skin does seem to go back to normal eventually.
But I'll stick to dyshidrotic - 2 docs with that diagnosis, and 2 that didn't know.
None were dermatologists by the way, family docs - it was a "and while I'm here, what is this?" thing.

Hardly ever eat spicy food - only the occasional very mild curry.
Stress - not much mental stress, but I'm guessing plenty of physical stress.
Up until this year I did not deal with heat/sunlight well (dizzy, eyes acting weird) so mainly stayed indoors.
I've now got a slight tan (arms) for the first time since I got cfids, which I take as : overall health still improving, albeit a 'bit' slow. *happydance*.

[Vanessa Lacuesta]

Hi,

Yes, heat may produce rash like conditions .This may be due to a photosensitivity reaction. The skin affected are areas that have been sun exposed or have been noted to be exposed to heat. Usually the areas are symmetrical. If a photosensitivity reaction is being considered, it is important to know which type. In these cases, avoiding direct sunlight exposure is necessary.

As for the hand condition,this sounds like dyshidrotic eczema. This starts as a dyshidrosis wherein the clear blisters with yellowish brown fluid within are seen clustered together.The blisters unlike that of the herpetic lesions are not fragile. Itchiness may be present and the excoriations caused by scratching may actually lead to involvement of normal skin causing eczema.

The eczema may recur again. The mainstay for prevention is avoiding extreme temperatures, certain food (spicy food etc),stress and mechanical injury in the area.

Your thyroid condition may be contributing here , but are the levels well controlled?