Episodes of itchy, blistery-looking bumps on the backs of my knuckles

Posted by zeiracorp @zeiracorp, Oct 30, 2018

This is an on-going case of flareups of viciously itchy, blistery-looking bumps on the backs of my hands, particularly the knuckles, which has never gone completely away. I've had it for a long time, and it flares up in episodes. I've recently had severe flare-ups, so it seems to be getting worse. I have clobetasol propionate cream which helps and takes about five days to two weeks to get it under control. The bumps look like blisters, but are solid inside – no fluid. They are pretty much only on my knuckles, on the back and sides of my fingers. My dermatologist thought it might be caused by soap, but I've tried all sorts of soaps and I'm no longer convinced soap is the culprit. I think it may be a symptom of something internal (viral?). I want to know what this stuff is, and if we can eradicate it. It is miserable, itches like poison oak. So far it has not spread to any other places but the backs of my hands, primarily the right one. My PA, based solely on the attached photographs and description (not an exam) thought it might be dishydrotic eczema, but I am getting referred back to another dermatologist (I requested a different one from the one I saw before). I want this gone. It is torturous.

Added: When this subsides, the skin dries and peels off of where the blister-looking places were.

Hi @zeiracorp and welcome to Connect! Those blistery-looking bumps sound awful.

You stated that your PA said it could be a type of eczema, so I'm tagging @gardeningjunkie as she has some experience with a few different types of eczema.

You said you've had it off and on for a long time. How long exactly has this been happening? Also, have you gotten that appointment with a different dermatologist scheduled?

@ethanmcconkey

Hi @zeiracorp and welcome to Connect! Those blistery-looking bumps sound awful.

You stated that your PA said it could be a type of eczema, so I'm tagging @gardeningjunkie as she has some experience with a few different types of eczema.

You said you've had it off and on for a long time. How long exactly has this been happening? Also, have you gotten that appointment with a different dermatologist scheduled?

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Thank you for responding.
I saw the first dermatologist in 2011 and from reviewing my records I see he did diganose it as "dishydrosis."

See updated photo.

P1200205-11-01-2018-1000-NOTES

I have personal experience with 3-4 forms of eczema, but dyshidrotic is not one of them. By now you know that eczema is a chronic disease (incurable) but with contact avoidance and or treatments symptoms may be minimized, controlled or hopefully eliminated.

Dyshidrotic Eczema, DE, is a more elusive form than the types I have, yet there is much that can be done. First off I have to say after viewing your excellent photos and descriptions your dermatologists seem to have correctly identified the type. I have no medical training, but living with eczema for 18 years now I have been researching and soaking up information which is the only reason I did not put a bullet in my brain because the pain and itching kept me from sleeping. Lack of sleep is a form of torture. Right now I am symptom free of all 3 forms, but I am diligent and have had to adjust my life style. Also have learned which meds help and regularly see several dermatologists. Will symptoms return at some time or will I developed another form, probably. Keep in mind it is common to have multiple forms because of our overactive immune system; always be on guard when different symptoms develop.

Right now go to DermNetNZ. It's an awesome eczema site, far better than the US site the National Eczema Association, NEA. The NZ site is user friendly, extremely informative and just now looked up the dyshidrotic form and I would have thought the photos you sent in were the examples they showed on their site. A perfect match. Some never can figure out what form they have and receive incorrect treatments.Both of my more recent forms Grover's Disease and Perioral Dermatitis were misdiagnosed, but because of another blogging site I will recommend later and personal research was able to march into the derms office with photos and treatments to try and they worked!! So right now you have a starting point. On the New Zealand site hand dyshsidrotic form is often related to a nickle allergy. Has the test been given, 5 Day Extended Patch test? Not the simple prick test for environmental allergies. This is the test to get diagnosed for nickel allergies. Medicare pays for this expensive test. Nickle is hiding in many places, not just in the coin, so until you get this test research places nickle may be and avoid them. This would include internal and external nickle. If nickle is aggravating your symptoms it will be better to stop what is causing your symptoms rather than keep treating them.

Most all derms want to give us a tube of steroid. Clobetasol p. is a steroid. Long term use of steroids changes the resiliency of the skin, often permanently. It thins it. I do understand the desperate need to calm the symptoms but ask about switching between classes of steroids. There are 5 classes, unfortunately my patch test showed I was allergic to one class with a cross over to 2 other classes so I can only use 2 classes. Also with chronic use of one class your body may start ignoring it, so switch around at least every year, which is hard because all topical steroids are expensive.

The blogging site that has helped me most is the Inspire site. Without it I wouldn't even know what was causing the rash around my mouth. Another member wrote in about symptoms and goodness, it matched what I was getting. Turns out my derm was treating me completely wrong- prescribing steroids. Steroids feed the Periora!!!!!. I also learned my nasal steroid triggered it as well as my occlusive topicals (all my topicals are petroleum based because of ACD allergy limitations, so by nature are occlusive). Inspire covers all conditions, like Mayo, so go to the eczema site. Real DE suffers like you will have helpful advice. Also research their old discussions on DE you will have good information.

You have tried different soaps searching for relief and although the only allergy I read about for DE contacts was nickel, a mild soap is always helpful. It will dry less. I have been using 1 soap exclusively for 5 years now, even as a shampoo. It's best as a shampoo with soft water, but an extra wash will accomplish is hard water and now no more scalp itch. In the last 6 months it got approved for the Mayo Skin Safe site. After my Patch test I had a list of all my allergies and with that could pinpoint what products safe for me. Grandm'a Soap (until listed by Mayo's Skin Safe site it was called Grandma's Lye Soap), a bar soap for face and body contains only 2 ingredients, Lye and Lard. During the soap making process the lye is converted into glycerin. Therefore the end result is glycerin and lard. Both are moisturizing. Their website explains this process. I love it. I keep a bar at each sink, besides the shower, and carry a bar in my purse as I am allergic to every soft soap provided in public restrooms. I order the 3 pack on Amazon, a fair price. Without the yummy fragrance of other soaps, but you will be left with a clean neutral smell. Now no more hand eczema, no more steroids for my hands, of course for me I had to change dish soap, laundry detergent and a host of other things you may not need to do as only your hands are irritated. Yet if looking for a good dish soap, one which I don't need to wear vinyl gloves for and doesn't dry my hands out and yet gives a pretty good lather try ecover zero, also Amazon, this is free of all my allergies, especially preservatives. I have tried many safe for me dish soaps and this is the best.

(Let me rant, why do the manufacturers think a bottle of dish soap or body soap needs to last 100 years? In recent years they took out the formaldehyde and replaced with other toxic preservatives to increase shelf life. Just like making a Twinkle last 100 years, good for them, bad for us. I am not allergic to formaldehyde, but did develop allergies to the replacement preservatives. At the very least stop using Dawn dishwashing liquid, it's a toxic stew, true nothing degreases like it, but even if not allergic it will dry your hands out. Many European countries stopped using several preservatives our American lobby groups say are acceptable because so few develop health issues and pressure our government to approve. Big money. Well I was the 5% that didn't tolerate and that's why I got hand eczema and I am not alone. Also get rubber free gloves, latex free doesn't mean rubber free. I had been told to wear protective gloves by derm, ok, easy except I turned out to be allergic to the gloves themselves.They were also a cause of my hand eczema. After patch test learned what was safe for me, vinyl or plastic ok. Best 100% vinyl, long lasting and comfortable are Clean Ones, pure Comfort Latex Free Gloves, which are 100% vinyl, women's sizes which run a bit small, Amazon. OK enough ranting.)

Hope I gave you some ideas on how to help yourself. 1. Go to dermnetnz 2. Go to Inspire 3. Ask derm about switching steroids occasionally 4. Order some safe soap and rubber free protective gloves when using drying cleaners. With eczema you must be proactive, derms cover hundreds of skin diseases and you only have to be concerned with learning all you can about your form.

@gardenjunkie – Thank you very much for the comprehensive reply. I'll look into your suggestions.
I have an appointment with a dermatologist's PA (never get to see a doctor) later this month. I think they want to do a biopsy, which might be a good idea.
I'll post back what I find out so others can learn from it.
Thanks again.

@zeiracorp I have this–it is dyshidrotic eczema. My bumps do have clear liquid in them. Occurs on hands (undersides of fingers and base of thumb usually) and feet. When I feel an itchy place starting and look closely, I can see these bumps forming under the skin–at first just as teeny dots of fluid, or an oh-so-slight set of bumps. These progress to bigger and more bumps, the skin drying and cracking and sometimes, whole patches sloughing off. It helps when washing my hands to use tepid, not hot water. I find Zim's Crack Creme does the most to heal breakouts (don't know why it is referred to as a cream–it's a very runny spray; they do have a cream, but the spritz spray works best for me). I also gave up hand-washing dishes.

@texasduchess

@zeiracorp I have this–it is dyshidrotic eczema. My bumps do have clear liquid in them. Occurs on hands (undersides of fingers and base of thumb usually) and feet. When I feel an itchy place starting and look closely, I can see these bumps forming under the skin–at first just as teeny dots of fluid, or an oh-so-slight set of bumps. These progress to bigger and more bumps, the skin drying and cracking and sometimes, whole patches sloughing off. It helps when washing my hands to use tepid, not hot water. I find Zim's Crack Creme does the most to heal breakouts (don't know why it is referred to as a cream–it's a very runny spray; they do have a cream, but the spritz spray works best for me). I also gave up hand-washing dishes.

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You personally have dyshidrotic eczema and shared that your rash has a similar appearance as zeiracorp's. This is valuable information. Many eczema's can be diagnosed by their visual appearance alone, so seems her docs are on target. Photos on various websites are extremely helpful in diagnosing eczema. This year I developed another form of eczema and thank goodness for photos as my doctor was treating it as my ACD. Completely wrong and it even fed this new form, Perioral. Thanks to photos on websites like dermnetnz, an informative New Zealand website that covers more forms of eczema than any other I have come across, even the less common forms as 2 of mine are, I found photos that matched my rash and it also listed treatments and I took that info to my derm. Within a week of the correct treatment and avoidances my rash lessened and after 3 weeks gone. It's been gone now for almost 2 months. Yet now I know what to avoid.

You mentioned giving up hand washing dishes. Hands which are unprotected from cleaning products, even if you are not allergic to the ingredients will be subject to irritation and dryness as you have learned. When your blisters are cracked and bleeding, the cracks will become deeper and peeling worse. I have a different form of eczema on my hands, ACD, which is caused by allergies and now have found products safe for my skin, but still only allow my hands to use for a few pots and pans for a few minutes. If I am washing a sink full of pots and pans I still use my "safe" protective gloves. Rubber allergies are very common and even "latex free" gloves contain rubber elements, they just don't contain the latex. In previous response I mentioned the terrific, long lasting and comfortable gloves I buy on Amazon which are 100% vinyl, completely rubber free. Also I hang with a large binder clip to dry completely inside. A bother yes, but I have learned to just do it. Also if your hands are in bad shape, like mine used to be with ACD before I learned which chemicals and elements I was allergic to I did a 3 stage process: rub on ointment, 100% cotton glove and then protective glove to speed up the healing process trying not to dry my skin. Trouble was I turned out to be allergic to inactive ingredients in the ointment as well as materials in the protective gloves. At least with ACD, once allergies are learned we can control breakouts, dyshidrotic is more of a mystery, like atopic is also. Some think those forms may be based upon genetics.

Thanks texasduchess.

@gardeningjunkie

You personally have dyshidrotic eczema and shared that your rash has a similar appearance as zeiracorp's. This is valuable information. Many eczema's can be diagnosed by their visual appearance alone, so seems her docs are on target. Photos on various websites are extremely helpful in diagnosing eczema. This year I developed another form of eczema and thank goodness for photos as my doctor was treating it as my ACD. Completely wrong and it even fed this new form, Perioral. Thanks to photos on websites like dermnetnz, an informative New Zealand website that covers more forms of eczema than any other I have come across, even the less common forms as 2 of mine are, I found photos that matched my rash and it also listed treatments and I took that info to my derm. Within a week of the correct treatment and avoidances my rash lessened and after 3 weeks gone. It's been gone now for almost 2 months. Yet now I know what to avoid.

You mentioned giving up hand washing dishes. Hands which are unprotected from cleaning products, even if you are not allergic to the ingredients will be subject to irritation and dryness as you have learned. When your blisters are cracked and bleeding, the cracks will become deeper and peeling worse. I have a different form of eczema on my hands, ACD, which is caused by allergies and now have found products safe for my skin, but still only allow my hands to use for a few pots and pans for a few minutes. If I am washing a sink full of pots and pans I still use my "safe" protective gloves. Rubber allergies are very common and even "latex free" gloves contain rubber elements, they just don't contain the latex. In previous response I mentioned the terrific, long lasting and comfortable gloves I buy on Amazon which are 100% vinyl, completely rubber free. Also I hang with a large binder clip to dry completely inside. A bother yes, but I have learned to just do it. Also if your hands are in bad shape, like mine used to be with ACD before I learned which chemicals and elements I was allergic to I did a 3 stage process: rub on ointment, 100% cotton glove and then protective glove to speed up the healing process trying not to dry my skin. Trouble was I turned out to be allergic to inactive ingredients in the ointment as well as materials in the protective gloves. At least with ACD, once allergies are learned we can control breakouts, dyshidrotic is more of a mystery, like atopic is also. Some think those forms may be based upon genetics.

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Thanks again gardeningjunkie

In my post on 11/17/18, I recommended Zim's Crack Creme (liquid spray) for dyshidrotic eczema. I am currently in the throes of major breakout completely across the backs of both hands as well as on the palms. I just realized that the two bottles of Zim's I have only have about 1/2 inch left in them AND there's no Zim's to be found online, or through their site–they tell me this product has been discontinued … NOOOOOO! The creamy daytime formulation that comes in a tube is still available, but when I tried it a few years back, I did not find it as effective as the spray. You can't buy online through Zim's anymore, but I did see other retailers carrying their products.

I am getting relief by using Isomers H-Pur 100 Advanced Moisture Magnet (a serum/gel of sodium hyaluronate–HMW and LMW); it's not cheap, but can be purchased occasionally from Evine, or directly from Isomers (Canada) in a more economical 16.9 fl.oz. size. I've used this for some years for my face and thought I'd give it a go on my hands since my Zim's is about gone. The H-Pur is very soothing and has stopped the maddening itch that was waking me from sleep as I clawed at my hands.

Liked by zeiracorp

@texasduchess

In my post on 11/17/18, I recommended Zim's Crack Creme (liquid spray) for dyshidrotic eczema. I am currently in the throes of major breakout completely across the backs of both hands as well as on the palms. I just realized that the two bottles of Zim's I have only have about 1/2 inch left in them AND there's no Zim's to be found online, or through their site–they tell me this product has been discontinued … NOOOOOO! The creamy daytime formulation that comes in a tube is still available, but when I tried it a few years back, I did not find it as effective as the spray. You can't buy online through Zim's anymore, but I did see other retailers carrying their products.

I am getting relief by using Isomers H-Pur 100 Advanced Moisture Magnet (a serum/gel of sodium hyaluronate–HMW and LMW); it's not cheap, but can be purchased occasionally from Evine, or directly from Isomers (Canada) in a more economical 16.9 fl.oz. size. I've used this for some years for my face and thought I'd give it a go on my hands since my Zim's is about gone. The H-Pur is very soothing and has stopped the maddening itch that was waking me from sleep as I clawed at my hands.

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Thanks for the update.

Does anyone know what these bumps are I've had them for years and they are very sore when I get them I have no clue what they are an can't find anything online about what they are but I have seen a lot of people with the same pictures trying to figure this out as well

IMG_20190215_160638

@racquel

Does anyone know what these bumps are I've had them for years and they are very sore when I get them I have no clue what they are an can't find anything online about what they are but I have seen a lot of people with the same pictures trying to figure this out as well

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Hi, @racquel – Welcome to Mayo Clinic Connect. I've merged your post into this discussion of finger bumps, so that you could speak to others who are talking about a similar issue. Click VIEW & REPLY to see the discussion and scroll through past messages.

Have you ever mentioned these bumps in an appointment with your general practitioner, @racquel? If so, what did he or she say about them? Have you found anything that helps at all with the soreness from them?

@lisalucier

Hi, @racquel – Welcome to Mayo Clinic Connect. I've merged your post into this discussion of finger bumps, so that you could speak to others who are talking about a similar issue. Click VIEW & REPLY to see the discussion and scroll through past messages.

Have you ever mentioned these bumps in an appointment with your general practitioner, @racquel? If so, what did he or she say about them? Have you found anything that helps at all with the soreness from them?

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I have mentioned these bumps to my primary care doctor and she didn't know what they we're so I've become unsure of what to do I have considered that they might be similar to warts and might try some of the home remedies for warts such as apple cider vinager or honey

racquel- There are hundreds of skin conditions and your primary care doctor should have recommended that you see a dermatologist to get a diagnosis. It's often hard even for a dermatologist, who specialty is skin, to determine without testing. Don't ignore these symptoms, if sore when you get them they could be a sign of something more serious: bacterial, a virus, contact allergy's or food allergies. If it is eczema a chronic disease it is for life and your symptoms will only become more severe with each exposure to the offending contact or food. I am not aware warts cause soreness. Apple cider vinegar can relieve itching in some with eczema, but before you just start guessing get professional advice. Your homemade remedies could even make it your symptoms worse.

In my case, I was referred to a dermatologist, but by the time my appointment came around, mine had spontaneously cleared up. She instructed me to contact them if/when it flares up again and I can come in for a biopsy. What will likely happen is: 1.) it will flare up again 2.) I'll call the dermatologist 3.) they will give me an appointment so far ahead that it will have cleared up again by the time I get there. The only thing I got from my doctors was the first time, years ago when I saw a dermatologist was a diagnosis and a tube of clobetasol propionate (which does work). I will try the things suggested by you folks here when it flares up again, and I thank you all for your input.

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