How to treat painful blisters on the hand that have a burning sensation?

Question

Hello doctor,

For the last two months, my 63-year-old mother, has had small blisters on her right hand.

They look like small mosquito bites, mostly on top of the fingers.

All fingers except the thumb are burning, or she is getting stubbed with needles.

She has pain mostly in the evenings. Sometimes they feel hot, sometimes cold. She had lots of pain when her hand went into the water, so she is using gloves.

Have you got an idea what this can be?

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.I examined your picture (attachments removed to protect the patient's identity).

1. Your mom is suffering from paronychia with maybe ingrown nails.

2. Paronychia is a soft tissue infection around a fingernail that begins as cellulitis but may progress to a definite abscess.

3. Acute paronychia is a painful and purulent condition most frequently caused by Staphylococci.

4. A fungal infection usually causes chronic paronychia (if the duration is more than six months).

5. Investigation includes gram staining and/or culture is done to rule out the bacterial cause.

6. Potassium hydroxide (KOH) 5% smears rule out the fungal cause.

7. If soft tissue swelling is present without fluctuance, the infection may resolve with warm soaks for three to four times daily.

If an abscess has developed, incision and drainage must be performed.

For the acute episode, one can take oral antibiotics like Augmentin 625 mg TDS (if not sensitive to penicillin group) with topical Fusidic acid cream plus Clotrimazole cream twice daily for five days.

However, please consult a physician, discuss with them and start taking the medications with their consent.

Do not cut nails from the side, you can cut from the front. In addition, once they grow, side nails pinch the skin and cause a recurrent problem.

Review after five days.

I hope this helps.

Thank you and take care.