pompholyx aka pomp holy sh*t

[Flippenfedup]

Hi to all, I'm new to all this,having not suffered from eczema for about 45 yrs. I grew up with eczema on wrists backs of knees inside elbows and that was about it really, can't remember it bothering me much from puberty onwards... fast fwd 40 yrs and for the past 5 yrs have had small annoying outbursts on fingers & palms only, then coming to a head last autumn when almost disabling my hands entirely and bafflingly attacking both feet.
I was referred to see a specialist dermatologist at the QE hospital Birmingham , rather disappointingly I was ushered away with a selection of creams and little hope of an end to all this. Using a mixture of topical steroids and moisturisers my hands are quite normal and look like my hands! my feet however are horrendous my ankles and achilles still disfigured sore oozing cracking stinging burning , I'm wincing as I write this,
Work is impossible, I can't even balance properly, wear any footwear other than mules, my god, never realised how important feet are! I work at a modern car manufacturing factory in Solihull alongside the production line maintaining the robots , tooling etc. it's a clean environment to work in and ppe is worn as specified so I don't really come into contact with any nasties. Hardly been to work this year its costing me money and I don't know how long sick pay will last...HELP!
I like to play ping pong and race off road motorcycles but it's all on hold...HELP!
My antibiotics end next week, got to see my GP again for what must be the tenth time this year even invested in a UV medical lamp ... even invested in a prescription pre pay card...HELP!

[Dr Anjali Mahto]

Many thanks for taking the time to post a question and I'm sorry you are having such a rough time with the pompholyx on your feet.

From what you describe, I would recommend that you see a dermatologist again. If your skin is not being controlled with high strength topical steroid ointments, emollient washes, and soap substitutes that suggests your treatment needs to be taken up a level.

It is possible to use light treatment (phototherapy) with UVA and a tablet or solution known as a psoralen (PUVA treatment) to treat severe or stubborn cases of pompholyx. Failing this, there are tablets that can be used which act on the immune system (e.g. methotrexate, azathioprine) which may help.

These are further options that are worth you exploring either with your dermatologist.

I hope this helps and best of luck.

Anjali

[saritasingh@doctors.org.uk]

I agree with my colleague, Dr Mahto. Regarding painful fissures and cracks, a topical steroid impregnated in a tape form (e.g. fludroxycortide tape) can be very useful. You could apply this overnight to treat specific cracked painful areas.