Hi,

Thank you for the query.

I would like to know few more things which would help me in suggesting you better:
1) What is the exact location of these blisters (is the sides of the fingers involved)?
2) How long she has been having this?
3) What treatment she has taken so far and what was the result?

You can even consider sending me a close up picture of the lesion which would help me further. You can send it at YYYY@YYYY and kindly mention "ATTN Dr.Bharat Chawda" as a subject or you can upload the pictures in the right side of the query box. Also please reply to this post saying that you have enclosed a picture.

At this moment the possibility of POMPHOLYX seems to be more likely. In this condition we get to see small blisters in hand associated with itching. This is considered as an allergic condition especially to metals.

The treatment option in such cases would be topical steroids along with oral antihistaminic and antibiotics.

Please reply back with the above answers and mail the photos if possible, as this will help me in answering you better.

Awaiting your reply.

Regards,
Dr.Bharat chawda.

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Hi XXXXXXX

Thanks for your reply and also for posting the pics. I have seen the pictures of the lesion.

With the above pictures and the history, there are certain possibilities which comes in my mind.
I would still go with the first possibility of POMPHOLYX, where in one gets multiple pustules and vesicles over fingers and hands associated with itching.

The next possibility would be of PYODERMA, which manifests as multiple painful pustules, which may or may not be associated with fever.

Third possibility would be of ACRODERMATITIS CONTINUA OF HALOPEAU.This again manifests as multiple pustules over fingers with involvement of nails and peeling of skin. In this the classical thing is that these pustules are sterile, unlike the case in pyoderma.

I would suggest that you get a gram's staining ( A laboratory test where microscopic examination of the sample from the lesion done), with culture and sensitivity of these pustules ( to find out the presence of causative bacteria) , along with a skin biopsy.

The treatment would be based on the above findings. So, I would suggest that you consult a Dermatologist who has these facilities and can help you with the treatment.

Presently for symptomatic problem she can take oral antihistaminics along with oral antibiotics.

If this is a Pyoderma, then this would be good enough.

But in other two cases (Pompholyx and Acrodermatitis) one would require Topical Steroids too.

So the treatment would solely depend upon the findings of these tests. kindly do consult a Dermatologist nearby for proper investigations.

If you want to discuss further, regarding your conversation with the dermatologist, you can always write back to us. I will be happy to answer them.

Wish your daughter and you a good health.

Regards,
Dr.Bharat chawda

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