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Dr. Andrew Rynne

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Suggest treatment for itchy red patches on fingers

Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8411 Questions

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Posted on Mon, 2 Nov 2015 in Skin Hair and Nails
Question: Dear Dr.
I am having red patches on fingers of hand.Later on silver colour scales formation is there.There is Kateratinisation on fingers skin.Cracks develops on skin which pains very much.There is intermittent itching on fingers.Skin remains dry and fishy.
XXXX
doctor
Answered by Dr. Kakkar S. 34 minutes later
Brief Answer:
Eczematous skin condition; Intensive moisturizer+potent steroid creams

Detailed Answer:
Hello XXXX. Thank you for writing to us.

I have gone through your query and I have noted down your concern.

The description of condition affecting the skin on your hands i.e red patches/ plaques along with scaling, fissuring and cracking, seems to match with an eczematous skin condition. I will keep a possibility of either Chronic cummulative irritant contact dermatitis, Plaque psoriasis Or Hyperkeratotic eczematous dermatitis.
I request you to kindly upload a few Images of the condition affecting your hands so that I am able to guide you better. You may upload an Image either at "Reports Section" Or else you may mail me a few iamges at the following email ID i.e YYYY@YYYY with the subject line as Attention:Dr.Kakkar.
I would suggest you to use an intensive moisturizing cream on affected skin, specially a urea, ammonium lactate based moisturizer e.g Amylac cream Or Lacsoft cream Or Ureative 20% cream, twice daily.
In addition to moisturizer, you also need to use a potent topical steroid cream e.g halobetasol propionate 0.05% Or clobetasol propionate 0.05% cream, twice daily, after you apply the moisturizer.
A tablet of cetrizine 10 mg once daily will provide you symptomatic relief from itching.
Use a gentle soap for cleansing your hands e.g Dove soap or Pears (Glycerine) soap. Avoid excessive use of soaps. Use moisturizer everytime you wash your hands.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 21 hours later
Dear Dr.
I have uploaded two images of my fingers.
Regards
XXXX
doctor
Answered by Dr. Kakkar S. 12 hours later
Brief Answer:
Psoriasis Or Hyperkeratotic Eczema; A skin biopsy would distinguish

Detailed Answer:
Hi. Thank you for the Images.

I would keep my possibilities as either Psoriasis Or Hyperkeratotic eczema. A skin biopsy would be confirmatory.
I would have managed it with a moisturising cream and potent topical steroids as suggested in my previous reply.
A moisturising cream e.g ammonium lactate based (Amylac cream) Or urea based (Ureative 20% cream) should be applied at least twice daily.
Specifically for the scaly, red patches I would suggest a potent topical steroid e.g clobetasol propionate 0.05% Or helobetasol propionate 0.05% cream, twice daily, over and above the moisturiser.
A tablet of cetrizine 10 mg once daily will provide you symptomatic relief from itching.
Topical steroids are prescription medications and I suggest you to use them under supervision of a dermatologist and for the required duration. Your dermatologist might also want to do a skin biopsy for a confirmatory diagnosis.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 17 hours later
Dear Doctor
If I go biopsy of skin,and it is diagnosed as PSORIOSIS OR HYPERKERATOTIC ECZEMA,then would the treatment changes or it remain same.
At present I have started the treatment suggested by U.How long I will have to taken treatment.What precautions I have to take for get rid of this aliment.
Regards
XXXX
doctor
Answered by Dr. Kakkar S. 48 minutes later
Brief Answer:
Can expect significant improvement with 2 weeks of treatment

Detailed Answer:
Hello. XXXX

Both these conditions i.e psoriasis or hyperkeratitic eczema would respond equally well to the above mentioned treatment modalities however a skin biopsy is an essential first step in pin-pointing the exact diagnosis. Ideally skin biopsy should be done prior to starting treatment Or else histopathology may get altered due to initiation of treatment leading to inconclusive histopathologic diagnosis. However, not all pathologists are good in accurately reporting skin histopathology related to various skin diseases and I would only recommend services of an experienced dermatopathologist who would be having considerable experience in reporting histopathology related to various skin diseases.
You can expect a significant improvement in your skin condition in about 2-3 weeks.
This condition may relapse after a seemingly complete cure. You must continue with the moisturiser indefinitely to reduce the chances of relapse. Steroid cream can be discontinued once the red, scaly patches have resolved.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 37 hours later
Dear Doctor

Should I use the same skin moisturizer for longer duration or we can use other moisturizers available in the market.

Is there any specific precaution to be taken to avoid relapse.
Regards
XXXX
doctor
Answered by Dr. Kakkar S. 4 hours later
Brief Answer:
Use a moisturiser frequently

Detailed Answer:
Hi.

You may use the same moisturiser, for a longer duration.
Avoid harsh soaps like dettol, lifebuoy etc. Use dove or pears (glycerine) soaps. Avoid frequent washing (some people do this to try to keep skin hydrated but it rather increases water loss from skin and leaves it dry). Use moisturiser every time you wash your hands

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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