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Skin Care and Diseases

Small very itchy blisters on hands

08/01/2006

Question:

I am a 46-year-old female with no prior allergies to anything. I have developed a small hard blister type rash on my palm of my left hand that spread between my fingers and as well over to my right palm and fingers. It has stayed on the palm side of my hand but is all over of my fingers. These are very very itchy burning and hurt if you apply direct pressure to them. The rash is very sensitive to hot, as I am not able to put my hands in hot water at all. This will make the rash burn and itch more. The blisters are very hard to pop, but if the blisters are raised enough, which they vary, a clear fluid comes out if you are able to pop them. After a few days of applying cortisone creams and taking Benadryl the rash seemed to be getting better then became tight and thick feeling. But then continued to spread more. I have always kept moisturizers on my skin because I have been diagnosed with CREST Syndrome, (early stages) I have to keep moisturizers on day and night. When the skin is stretched, it will burn. I work in an office that I have been at for over 8 years with no changes in my environment except a new desk chair. I thought it could possible be a new car steering wheel cover, but I removed that and it continues. It has been about 3 weeks now and the original area that first developed (left palm) is now just dry and stiff almost like a burn scar. A different type of skin feeling than before. Is it possible for people to get skin problems or allergies after 40? I have not been able to get in to see a demonologist, as there are only a few in my area. The itching is quite bad with me itching through the night. In addition, I am worried that my skin on my hands will look and feel like scar tissue. HELP….Itchy-Itchy

Answer:

You describe dyshidrosis which is caused by irritating cleansers and very likely is only minimally related to your CREST Syndrome.  By cleaning with nonirritating waterless cleaners such as Cetaphil, Purpose, and others, and using moisturizers on a regular basis, the process will subside.  I would urge you to use a medium-strength steroid topically during the acute phase to help the itching and burning. You should be followed by both your board certified dermatologist and your internist, who I assume is taking care of your scleroderma. 

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati