[44F] With hand eczema, fluid in lung, and upper back pain

Patient Description

A 44-year-old female has been experiencing extremely itchy, red, and sometimes pus-filled eczema on her hands for a few months. The symptoms appeared suddenly and have no identifiable triggers. She has been using Clobetasol cream for about two months, applying it at least five times a week, which has provided some relief. Additionally, she is experiencing knife-like pain in the middle of her upper back, which started today but was also present a few months ago, leading to a hospital visit. The pain is accompanied by shortness of breath but no numbness, tingling, chest pain, cough, fever, wheezing, or difficulty breathing deeply. There is no swelling in the legs or ankles. During her last hospital visit, she was informed of fluid in her lung and an abundance of skin cells in her urine. She has been living in a home with mold exposure for the past four years and uses an air purifier. Her medical history includes degenerative disk disease diagnosed 29 years ago, and she is allergic to Ceclor. She is not currently taking any medications.

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Arora's Assessment

What might be happening

It is likely that your symptoms are related to multiple issues, including existing diagnoses. If you have more questions, we can continue chatting.

Hand Eczema

  • Diagnosis: Your symptoms of extremely itchy, red, and sometimes pus-filled skin on your hands are consistent with hand eczema. This condition can be triggered by various factors, including allergens, irritants, and environmental factors like mold.
  • Treatment: Typical treatments include topical corticosteroids like Clobetasol, moisturizers, and avoiding known triggers. In severe cases, oral medications or phototherapy may be recommended.

Upper Back Pain and Shortness of Breath

  • Diagnosis: Given your history of degenerative disk disease, your upper back pain could be related to this condition. However, the presence of fluid in your lung and shortness of breath raises concerns about other potential issues, such as pleural effusion (fluid around the lungs) or an infection.
  • Treatment: Treatment may involve addressing the underlying cause of the fluid in your lung, which could include antibiotics for an infection or other interventions. Pain management for your back pain may include physical therapy, pain medications, and lifestyle modifications.

Fluid in Lung and Skin Cells in Urine

  • Diagnosis: The fluid in your lung could be due to various causes, including infections, heart failure, or exposure to mold. The presence of skin cells in your urine may indicate a contamination or a skin condition affecting the urinary tract.
  • Treatment: Further testing, such as imaging studies and urine analysis, may be needed to determine the exact cause and appropriate treatment.

What you can do

Hand Eczema

  • Continue using Clobetasol: Apply as directed by your healthcare provider.
  • Moisturize regularly: Use fragrance-free moisturizers to keep your skin hydrated.
  • Avoid triggers: Try to identify and avoid any potential triggers, such as harsh soaps or chemicals.
  • Consult a dermatologist: If your symptoms persist or worsen, seek advice from a dermatologist for potential alternative treatments.

Upper Back Pain and Shortness of Breath

  • Seek medical attention: Given the combination of back pain and shortness of breath, it's important to consult a healthcare provider to rule out serious conditions.
  • Pain management: Use over-the-counter pain relievers like ibuprofen or acetaminophen, and apply heat or cold packs to the affected area.
  • Maintain good posture: Practice good posture and ergonomic techniques to reduce strain on your back.

Fluid in Lung and Skin Cells in Urine

  • Follow up with your doctor: Schedule a follow-up appointment to discuss the findings from your previous ER visit and any additional tests that may be needed.
  • Address mold exposure: Consider professional mold remediation to reduce exposure and potential health risks.

What you should look out for

Given the severity of your symptoms and the possibility of life-threatening causes, you should seek medical care as soon as you can. Reasons to seek care even more urgently include:

  • Worsening shortness of breath: If you experience increased difficulty breathing, seek immediate medical attention.
  • Chest pain: If you develop chest pain, seek emergency care.
  • Fever or signs of infection: If you develop a fever, chills, or other signs of infection, consult your healthcare provider.
  • New or worsening symptoms: Any new or worsening symptoms should be evaluated by a healthcare professional.

Remember, while I can provide information and suggestions, it's important to consult with real health professionals for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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5 mo ago

People Also Ask


What are common triggers for hand eczema and how can they be avoided?

Common triggers for hand eczema include allergens, irritants like harsh soaps or chemicals, and environmental factors such as mold. To avoid these triggers, use gentle, fragrance-free products, wear gloves when handling irritants, and maintain a clean environment.


What could cause fluid in the lungs and how is it treated?

Fluid in the lungs, or pleural effusion, can be caused by infections, heart failure, or exposure to irritants like mold. Treatment depends on the underlying cause and may include antibiotics for infections, diuretics for heart-related issues, or procedures to remove the fluid.


How can degenerative disk disease contribute to back pain and what are the management options?

Degenerative disk disease can lead to back pain due to the breakdown of spinal disks, causing inflammation and nerve compression. Management options include physical therapy, pain medications, lifestyle changes, and in some cases, surgery.


What are the potential health risks of long-term mold exposure in the home?

Long-term mold exposure can lead to respiratory issues, allergic reactions, and exacerbate conditions like asthma. It's important to address mold problems through professional remediation and maintain good ventilation to reduce health risks.


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