skin problem?

[brittany44]

I'm writing you guys hoping you guys could help my dad. He will be 52 this year and for about 7 years this has taken over his life. I love my dad very much and i'm tired of seeing him suffer. I want him to have a normal life not be in pain constantly. This problem just keeps gettin worse and no matter how much money we spend seems like no one can figure it out or know how to treat it. This stuff is only on his hands. He speculates that he got it out when he worked at an asphalt plant working with could be contaminated diesel fuel or he thinks it could be an allergic reaction to lime dust because shortly after this problem started. It starts out looking like a zit or a boil and if he leaves them alone it builds into a calluse and grows bigger and bigger. They hurt him so bad to where he has to kid and pull them out to relieve the pain and pressure that is built up. I cant even imagine the pain he goes through everyday picking out these things. He has lost so much weight and is starting to go down hill since it consumes his day and night. It tears me up seeing him like this. We dont have much money or insurance so there is not much we can do. But these things underneath the surface of the matter are layers of hair like to the size of a rice grain (there mostly white sometimes brown) we dont know what they are but there are hundreds of them under all his skin. They vary in size some are small to where they look like a fiber to as huge as a rice grain. But it seems the top layer is the smaller to medium size and underneath those are the rice looking. The big round ones are like a zit and has its own membrane ( when you squeeze them with the tweezers they pop). The smaller ones are like silicone (kinda sticky) to were he has to let them dry out before he can grab them since there so heavily rooted in his skin. He has been to 3 dermatologists and about 3 different doctors and surgeons. They all came up with different diagnosis from it being a wart to it being prurigo nodularis (pn). They all treated him basically the same from prednisone to steroid cream to steroid shots to fungi cream to coalfilm for the wart. It seems like moisture spreads it. So many weird and other things im leaving out just because theres so much. But please if you have and ideas or suggestions on what to do please let me know.

[maatson]

Brittany, After seeing the photoes I need to revise my diagnosis! From the descriptions and the photoes it is a far cry! The lesion does not look like 'chloracne' which in reality look more like acne blackheads,
Here it looks more like a  primary Lupus Vulgaris with secondary myasis (Parasitic fly larvae)
Do consult your doctor.Best wishes.

[brittany44]

thank you for your advice! ill ask his doctor on that! i did post pictures on my page in an album on what it starts out as, to what he pulls out of his hand to what it currently looks like....thank you!

[maatson]

Chloracne.Once chloracne has been recognised, the source of exposure must be identified and the affected individual and other workers must be removed from exposure to  it.Best wishes.

[brittany44]

sorry it took so long to get back! Thank you for your help i appreciate it...and we have had 3 biopsys but still came up with the (pn) or something else. I read about how a guy just started using atenolol and his medication caused his prurgrio nodularis and how he stopped taking it and it helped him to a point where it does not bother him. And my dad just started taking atenolol and avalide around the time he noticed this stuff on his hands. So his doctor told him to see if being off of that for a month or so would help. and it did for awhile and now its back and new patches are starting on his hand! so if you have any other advice i would love to hear it? or suggest anything? thank you!!

[Bhupinder Kaur, MD]

Hello,
It is very difficult to confirm a diagnosis without examination but it can be Epidermolytic hyperkeratosis or nodular fibromatosis. In nodular fibromatosis, non-malignant thickening of the hands or feet deep connective tissue occurs where nodules or cords start growing along tendons of the foot. I suggest you to get an evaluation done from a dermatologist and get a biopsy skin done.

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.