[52F] With severe hand itching and skin issues

Patient Description

A 52-year-old female has been experiencing severe itching, particularly between the fingers and on the palms of her hands, for 8 months. The itching is intense enough to cause skin damage and oozing of a clear liquid. The patient finds temporary relief using Benadryl and notes that symptoms worsen after exposure to water and during the night. The patient has a history of wearing nitrile gloves as a cook, which coincides with the onset of symptoms. Additionally, the patient reports having 20 blisters on the right hand and 9 on the left hand, which are red, raised, and itchy. The blisters ooze and subsequently lead to dry, cracked skin. The patient has been dealing with this cracked skin for 6 months. The skin is described as tight, scaly, itchy, and red, but there are no changes in nail color or shape and no signs of infection. The patient has no known pre-existing conditions, is allergic to ibuprofen, and recently started taking Chantix two weeks ago.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • Contact Dermatitis: This is a type of skin inflammation that occurs when substances touching your skin cause irritation or an allergic reaction. The substances could be your gloves or soap. Irritant contact dermatitis can cause dry, cracked, scaly skin and blisters.

    • Treatment usually involves avoiding the substances that caused the reaction, and applying creams and ointments to help with the symptoms.

  • Eczema (Dermatitis): A condition that makes your skin red and itchy. It's common in children but can occur at any age. Eczema is long lasting and tends to flare up periodically. It may be accompanied by asthma or hay fever.

    • Treatment for eczema includes avoiding irritants and applying creams and ointments to help with the symptoms.

  • Psoriasis: This is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp. Psoriasis is a chronic disease that often comes and goes.

    • Treatment usually involves creams and ointments to help with the symptoms, and sometimes light therapy or medications.

What you can do

  1. Avoid scratching the affected areas as this can worsen your symptoms and increase your risk of infection.
  2. Keep your skin moisturized. This can be done by applying a hypoallergenic and fragrance-free moisturizer (like petroleum jelly) several times a day.
  3. Avoid irritants that may trigger or worsen your symptoms. This may include certain soaps, detergents, and even the nitrile gloves you mentioned.
  4. Over-the-counter treatments like hydrocortisone cream can help with the itching and inflammation. Antihistamines like Benadryl can also help with the itching.
  5. Keep your hands dry and avoid prolonged contact with water. When washing dishes or cleaning, you may want to consider wearing protective gloves made of a different material that doesn't irritate your skin.

What you should look out for

If your symptoms persist or worsen, it's important to seek medical attention. You should also seek medical attention if you notice signs of infection, such as increased redness, warmth, swelling, or pus from the affected areas.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

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People Also Ask

What are the common causes of contact dermatitis?

Common causes of contact dermatitis include exposure to irritants such as soaps, detergents, and certain materials like latex or nitrile gloves. Allergic reactions to substances like fragrances, preservatives, or metals can also cause contact dermatitis.

How can I differentiate between eczema and psoriasis?

Eczema typically presents as red, itchy patches that may ooze or become crusty, often associated with a history of allergies or asthma. Psoriasis, on the other hand, usually appears as well-defined red patches with silvery scales and is often found on the elbows, knees, and scalp. A healthcare provider can help differentiate between the two based on symptoms and possibly a skin biopsy.

What are some effective treatments for severe itching and skin blisters?

Effective treatments for severe itching and skin blisters include topical corticosteroids to reduce inflammation, antihistamines like Benadryl for itching, and keeping the skin moisturized with hypoallergenic creams. Avoiding known irritants and allergens is also crucial.

How can I prevent skin irritation from wearing gloves?

To prevent skin irritation from wearing gloves, consider using gloves made from alternative materials that do not cause irritation, such as cotton liners under nitrile gloves. Ensure hands are dry before putting on gloves, and moisturize hands regularly with a fragrance-free lotion.

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