Saturday, July 14, 2007

Fingertip Eczema

The patient is a 52 yo warehouseman with a two year history of a painful fingertip eczema of the first three fingers of his right hand and first four fingers of his left (dominant) hand. He handles cardboard boxes and drives a fork lift. He is also an avid golfer. The dermatitis is not seasonal.



He has been only minimally helped by super-potent topical corticosteroids.

Patch testing is scheduled but all we have available here is T.R.U.E. Test. If not helpful, he will be sent to an occupational dermatology department for further testing.

I assume this is an occupational contact dermatitis and have recommended that he use cotton gloves at work if possible.

Your ideas as to etiology and treatment pending definitive patch testing will be appreciated.

7 comments:

  1. Dear David,
    It may be a frictional dermatitis from the cardboard or even psoriasis. Does he wear a glove playing golf. Mind you , you do not hold the club in your fingertips! Handle tulip bulbs or garlic or glues?

    ReplyDelete
  2. Ben BarankinJuly 18, 2007

    Frictional or allergic contact dermatitis is high on the list. I'd use Prevex-HC or Prevex-B tid-qid, reduce soap use (use cleansers). Another option is a short course of prednisone to reduce severity, and then followed by topicals.

    ReplyDelete
  3. comment from Dr. XYZ

    ReplyDelete
  4. Hi

    I was amazed by the comparision with my fingers. I have exactly the same problem for 5 years now. Nobody could solve it, altough I already saw 4 docters on it.
    Do you know a solution for this? does de man still has it? you may email me or reply on this blog?

    ReplyDelete
  5. I've got the same condition. Had it for a little over three years. Seen many doctors and tried countless creams. Found out what triggers it through tenacious observation driven by intense pain but mostly by shear luck. My cell phone is the culprit. In addition to the cell phone I get a similar reaction while poking at my laptop. Connection? I'm thinking wireless apparatus. Microwaves concentrating around these devices have na adverse eefect on the finger tips because lack of mass makes them succeptable. I also have some metal in my arms. I'm thinking this might have a resonating effect making my situation different than most.

    I have also found something that puts me on track to relief. Besides putting the phone down, when I eat green cabbage I get a burst of skin rejuvination.

    Beleive me, I feel your pain. I still do not have confirmation on the root cause but am getting close. Call me crazy, call me a stretch. I'd rather you call in a tell me if I'm onto to something...

    ReplyDelete
  6. Have the same problem. For me it was mycosis. Need to be treaten by Lamisil and Triderm minimum 3-4 weeks. Also with hand protection using gloves

    ReplyDelete
  7. I have the same problem too, but it disappears after 2-3 months, after using feetcream with urea (for my hands, of course) and reappears as 2-3 months. Maybe it's the Lyme / borreliosis. I was diagnosed.

    ReplyDelete

We welcome your comments. We endeavor to serve your patients and you. If you want us to respond, please add your name and email address. Some people have trouble uploading comments. In that case, please send comments directly to djelpern@gmail.com. Thank you.