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Red and itchy rashes appeared on knuckles and wrist. Any treatment?

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Practicing since : 2005
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My 17 year old son has a bright red rash that appears solely on his knuckles and wrist of both hands, not the areas in between. Nothing on the palms or in between fingers. Small patches of bumps (flat papules) appear on the wrists. The bumps do not appear on knuckles, just redness. He complains that the rash burns more than it itches. He's had it for nearly 2 weeks. The burning sensation dissipates when the rash is treated with neosporin) but is short-lived. His knuckles appear slightly swollen. Don't know what it is attributed to or how to treat it. He works at a fast food restaurant for past 6-7 months, but never developed a problem before. In fact he used to work 3-5 days a week, and now only works 1 day/week for past 2 mos. He does wear latex gloves when handling food or cleaning bathrooms. Because of the timing and that this has not happened before, we don't think it is work related. He does have kitchen duty at home washing dishes. We think it might be a recent change in dishwashing detergent. Either way I'd like to know how to treat the rash and give him relief.
Sat, 15 Dec 2012 in Skin Rash
Answered by Dr. Pravin Banodkar 1 hour later
I would be pleased to answer your question .

From the description of the lesions they seem to be either a hand eczema or contact dermatitis.
Burning more than itching is a sign of some irritant which might be the new detergent and can be localized like how he is getting .

Here is what will help:

1. Clobetasol propionate cream + Mupirocin cream: Mix and apply over the affected area on the right shoulder twice a day for 14 days then switch to Fluticasone propionate cream once at night for 2-4 weeks. The specialist to see will be a dermatologist and he or she can prescribe these for you. Nothing over the counter will help much, the only product with some benefit is 1% Cortizone cream.

2. Tab Claritin 10 mg twice a day for 14 days, then once a day for 6-8 weeks. Initially the dose can be increased to 2 tablets taken twice a day if there is insufficient relief in itching.

3. Sarna sensitive lotion can be used 2-3 times a day to give further relief from itching. This can be continued even when the above creams have been stopped.

4. Avoid scratching the affected areas as much as possible. This is most important. Whenever it is not bearable soak a towel in ice cold water and keep it on the affected areas or apply the Sarna sensitive lotion.

Lastly keep the affected areas as well moisturized as possible with a moisturizer of your choice.

NOTE: 1% Cortizone cream, Claritin and Sarna lotion can be bought without a prescription.

Please feel free to ask if you have any queries.
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