Can't get a diagnosis of an ongoing skin condition!

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WhenIm64
Posts: 2
Joined: Mon Oct 12, 2020 4:56 pm
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by WhenIm64 on Mon Oct 19, 2020 2:22 pm

Can't get a diagnosis of an ongoing skin condition!

Hello, I have already emailed with my problem. But here it is again. I am a 64 year old female who has Hashimotos, also I have N.A. fatty Liver and therefore I try to take good care of myself, already have dry skin and am constantly moisturizing it. 4 months ago I got a pustule under my thumb on my left hand. I did not know what it was, but it grew and eventually the skin around it got sore and the skin flaked and eventually (and due to lock down it was impossible to see my GP!) there has been no real diagnosis. I have taken myself to A&E twice as it is sore and swollen and the skin is peeling off and cracks when I move it. Thank God I am right handed but still, it is painful and raw. I was told to put antibacterial creams on it and given a course of antibiotics, did not work. I was told to take more antibiotics and anti fungal cream, did not work, just got worse, then another dose of antibiotics and steroid/antibacterial/antifungal cream all in one tube, still did not do a thing for it! The Dermatologist who I had to go through A & E to get to, as I could not get an appointment says for me to take 8 tablets of Pregnelone for 7 days, twice (so for 2 weeks) and to put an anti fungal cream on it twice a day. Now I suffer from Hashimotos which already makes you immune system compromised so wouldn't that just set me up for No immune system as steroids do this? I just do not know who to take the advice from, as my hand gets worse and worse, PLEASE help me? Thank you! I have added two of the latest pictures but I sent an email to you with more. Please check them out.
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This is the most recent pic of my left hand
This is the most recent pic of my left hand
my hand Oct 12 2020.jpg (48.01 KiB) Viewed 2745 times
my thumb is so swollen and sore
my thumb is so swollen and sore
my hand October 12 2020.jpg (70.86 KiB) Viewed 2745 times

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Dr Anton Alexandroff
Posts: 435
Joined: Tue Sep 18, 2012 9:11 am
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by Dr Anton Alexandroff on Tue Oct 20, 2020 10:40 am

Re: Can't get a diagnosis of an ongoing skin condition!

I am so sorry to hear about your thumb! From your picture and history it potentially can be a pustular psoriasis of hand. I understand your concerns about oral steroid tablets in the light of risk of coronavirus infection. You really need to be seen and treated by your dermatologist in person. Perhaps you could ask him if a very strong steroid ointment (Dermovate ointment ) or a tablet which does not affect immune system (acitretin) would be helpful in your case. Acitretin can rarely affect liver tests so it should be done under a strict blood tests monitoring, especially as you already have fatty liver. Sometimes there is a need to take a skin biopsy to confirm diagnosis which your dermatologist can arrange. I hope you do not smoke (pustular psoriasis is often seen in smokers). I hope all goes well and will clears quickly.

With Best Wishes,

Dr Anton Alexandroff FRCP(UK) PhD CCT(Derm) FRSM FAAD
Consultant Dermatologist and Honorary Senior Lecturer
The British Skin Foundation Spokesperson
The British Association of Dermatologists Spokesperson For Media
London, Cambridge, Leicester and Bedford

http://www.alexandroff.org.uk
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Dr Anton Alexandroff
Consultant Dermatologist, Honorary Senior Lecturer & BSF spokesperson - FRCP, CCT (Derm), PhD, FRSM, FAAD

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WhenIm64
Posts: 2
Joined: Mon Oct 12, 2020 4:56 pm
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by WhenIm64 on Tue Oct 20, 2020 11:46 pm

Re: Can't get a diagnosis of an ongoing skin condition!

Thank you Dr. Alexandroff,
That is good to know, at last a diagnosis!
I have smoked in my past but quit almost 6 years ago now.
I think stress is probably more to do with it?
I will take your advice and thank you so much for your time and wisdom.
:)

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Dr Anton Alexandroff
Posts: 435
Joined: Tue Sep 18, 2012 9:11 am
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by Dr Anton Alexandroff on Wed Oct 21, 2020 10:55 am

Re: Can't get a diagnosis of an ongoing skin condition!

Not at all, delighted to be of help.
This is excellent that you stopped smoking. Of course stress always makes skin worse.
Hope all clears very soon.

With Best Wishes,

Dr Anton Alexandroff FRCP(UK) PhD CCT(Derm) FRSM FAAD
Consultant Dermatologist and Honorary Senior Lecturer
The British Skin Foundation Spokesperson
The British Association of Dermatologists Spokesperson For Media
London, Cambridge, Leicester and Bedford

http://www.alexandroff.org.uk
Instagram your_skin_dr
Twitter your_skin_dr
Dr Anton Alexandroff
Consultant Dermatologist, Honorary Senior Lecturer & BSF spokesperson - FRCP, CCT (Derm), PhD, FRSM, FAAD

http://www.talkhealthpartnership.com/on ... ndroff.php

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Dr Anton Alexandroff
Posts: 435
Joined: Tue Sep 18, 2012 9:11 am
Quote

by Dr Anton Alexandroff on Wed Oct 21, 2020 10:55 am

Re: Can't get a diagnosis of an ongoing skin condition!

Not at all, delighted to be of help.
This is excellent that you stopped smoking. Of course stress always makes skin worse.
Hope all clears very soon.

With Best Wishes,

Dr Anton Alexandroff FRCP(UK) PhD CCT(Derm) FRSM FAAD
Consultant Dermatologist and Honorary Senior Lecturer
The British Skin Foundation Spokesperson
The British Association of Dermatologists Spokesperson For Media
London, Cambridge, Leicester and Bedford

http://www.alexandroff.org.uk
Instagram your_skin_dr
Twitter your_skin_dr
Dr Anton Alexandroff
Consultant Dermatologist, Honorary Senior Lecturer & BSF spokesperson - FRCP, CCT (Derm), PhD, FRSM, FAAD

http://www.talkhealthpartnership.com/on ... ndroff.php

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Thivimaru
Posts: 17
Joined: Mon Oct 19, 2020 8:42 pm
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by Thivimaru on Thu Oct 22, 2020 8:01 pm

Re: Can't get a diagnosis of an ongoing skin condition!

I'm sorry that you have had such a difficult time with your hand, it must have been very distressing for you and looks sore.

The history you describe of a pustule developing initially could suggest pustular psoriasis however I would also recommend a sample being tested to exclude a fungal infection, particularly as the rash only affects one hand and the rest of your skin is clear.

Best wishes
Dr Thiviyani Maruthappu
Consultant Dermatologist

https://www.talkhealthpartnership.com/c ... maruthappu

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