Hi doctor,
I have recently had small tapioca-like bumps underneath the palm of my right hand (I have attached the photos, kindly have a look at it). My skin gets fairly dry in the winter due to extremely cold climate in my country, and sometimes my hands dry out and crack. The bumps seem to be around where the skin has broken. I recently started taking Aerius allergy medicine and Benadryl, as well as an Aveeno Oatmeal Anti-Itch cream. Does it look like I am also getting an allergic reaction to one of these? A few notes about me: I am a chef. I wash my hands very frequently (50 to 100 times daily). I also use hand sanitizer almost daily. I use heavy cleaning solutions and latex gloves a lot (possibly allergic to latex), and I butcher lots of fish and red meat daily. I have susceptible skin and dry skin, especially in winter. Two of my cooks have bad eczema on their hands. Is it possibly that it was transferred to me (small chance)? Is it possible my body has developed a mild case of Dyshidrotic Eczema (Palmar Dyshidrosis) or (cheiropompholyx) or palmar-plantar pustular psoriasis or possibly just an allergy? As my right-hand palm has always been a bit itchy in the dry winters, but never this severe. Will it spread or worsen? I will be seeing a doctor either tomorrow or the next day, and I just wanted to get a better idea before I go in. Thank you.
Hi,
Welcome to icliniq.com.
I have reviewed the attached photographs (attachment removed to protect patient's identity). I can appreciate red plaques on the backside of the hand in two of them, while in the third one, I can see dryness on the palm. According to me, it is neither psoriasis nor dyshidrotic eczema. It is definitely a case of hand eczema. Your occupation also makes you prone to hand eczema because of the points you have mentioned in the notes. Hand eczema is very common in atopic eczema. You have also mentioned about dry and sensitive skin in winters, which is also seen in atopic eczema. Hand eczema cannot be transferred from other individuals. The occurrence depends on the internal sensitivity of the individual. It can be because of anything you are using on your hands like sanitizers, gloves, solutions, or soaps. It can also be due to the frequent use of water. The cause can be found out by going for allergy tests. You need to avoid frequent washing of your hands and keep them moisturized by a regular and liberal application of moisturizers. Besides this, in severe flares, you need to apply steroid cream on the affected areas along with oral antihistamines. I hope to have answered your query. Good luck. Regards.
The probable causes are soaps, solution, gloves, sanitizers, and water.
Investigations to be done:Do serum IgE (Immunoglobulin E) levels and patch tests.
Probable diagnosis:The probable diagnosis is hand eczema.
Treatment plan:As mentioned above.
Preventive measures:As mentioned above.
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