Strange Dry Skin Problem On Hands

[pfieldhouse]

From you description of you condition it does sound like some sort of eczma or psoriasis. These can be notoriouslt difficult to treat, often the best result is to keep it under control with steroids.

This is a long shot but worth a try, you mentioned that you used latex gloves. In the UK more and more nurses are not using latex gloves due to allergic reactions. My ex wife developed this problem, the answer is to use vinyl or (the much more expensive nitrile gloves that will prevent this.

Like I say this is a long shot and I don't think it is the cause of you problem however it may be worth looking into.

Regards

Paul

[Morbius]

Morbius, is the condition similar to having dabs of superglue on your hands?

<{POST_SNAPBACK}>

Yes, it does very much look like this. Your description of the symptoms is correct.

[Morbius]

From you description of you condition it does sound like some sort of eczma or psoriasis. These can be notoriouslt difficult to treat, often the best result is to keep it under control with steroids.

This is a long shot but worth a try, you mentioned that you used latex gloves. In the UK more and more nurses are not using latex gloves due to allergic reactions. My ex wife developed this problem, the answer is to use vinyl or (the much more expensive nitrile gloves that will prevent this.

Like I say this is a long shot and I don't think it is the cause of you problem however it may be worth looking into.

Regards

Paul

<{POST_SNAPBACK}>

Thanks for the advice, Paul.

Yes, I started to use latex gloves, but that was AFTER my condition appeared. The purpose of using gloves was to avoid direct skin contact with some products such as detergents. Other in this forum have, just like you, advised me against using latex products (see posts hereabove) and I have followed their advice: I have stopped using those latex gloves. But that was a few months ago, and the symptoms are still there. Therefore, as you said, this cannot be the cause of my problem. However, it might have been an aggravating factor.

[jomama]

First of all, thanks to all. This is very valuable feedback.

Based on your comments, I'll bring some precisions now.

ProThaiExpat, your guess was right: the condition affects secondarily the back of my hands, especially on the articulations, and thirdly (but this is very minor) my elbows. No other part of my body is affected. But are you sure that this necessarily rule out any cause in the weather, air condition or water? My feeling is that, while those factors may not be the main cause of my problem, some could have contributed to make things worse. I hope that, with the wet season coming soon, I will get better...

I do not work with my hands or with any kinds of chemicals or so. I wash dishes with plain water or mild soap, and I wear gloves when I do so (based on my dermatologist's advice, before I did not!). Besides this, I have always been hygiene conscious, washing my hands several times a day (perhaps too much!), and I have even been called "hygiene maniac" by some! (especially those who saw me avoid to touch external objects such as handling poles in the train,  escalator hand rails, door handles - except at home - ...). Ironically, this did not prevent problems to happen...

I do not think that I have callousness problems. In fact, my dermatologist said that the skin of my hand  is very thin. So, there is really nothing that I can peel here!

Slimdog, it looks like your doctor gave similar advice. I will continue to use the Aristocort A cream my doctor prescribed, although I think that, as for now, it had no effect at all.

John, the story you relate is interesting as it shows that a change of environment can generate those kind of problems. I will travel to Singapore next month, so we shall see if this has any effect on my condition, although my trip may be too short (just a few days) to have a real effect... As for the food, I doubt it could be the cause. Here again, I am extremely cautious about what I take, especially when I eat outside, and I am also a quasi vegetarian. Besides this, I have no problem with my face skin at all. I agree with your idea of eliminating things one by one. I have stopped using any of those cleaning products at home without wearing gloves (I didn't use much of them before, anyway). But this had no effect on my condition. I wish to try  this anti-bacterial soap you mention: could you specify what it is? Is Dial the brand name? And where exactly at MBK can you find it?

I think that there are 2 steps in the resolution of my problem: 1. To get  rid of it. 2. To prevent it from coming back. Right now, I am working at step 1.

What makes me feel better:

* Washing my hands with water only, although I know it is not recommended.

* Wearing those thin latex medical gloves. Sounds silly but I think this prevent dryness.

* Using those hand creams that were prescribed by my doctor. However, as I said earlier the relief is temporary only, and after the product has dried, the condition appears again. Unfortunately, all in all, I think that my condition has deteriorated after I started the treatments (which is my I decided to post here in this Forum!)

What makes me feel worse:

* Touching paper, like when I read a book or newspapers.

* Being in an air-conditioned place, so I have reduced it at home.

* Keeping my hand immobile ("frozen" like), like when I handle the mouse of my computer.

<{POST_SNAPBACK}>

Sorry to get into this thread so late, but I just found it. Last year I was hospitalized in emergency care with what turned out to be psoriasis that had covered virually my entire body because it was misdiagnosed.

It started many years ago on my index fingers, but would come and go. Then I got it on my elbows, armpits, and butt. It then hit my lower legs very hard. Eventually I had severe dandruff on my head and swollen feet --- literally head to toe. After they finally diagnosed it, I was sent a specialist and he put me on a drug called Methotrexate. After a couple of months I cleared up and stopped taking the drug because of side effects. A year later some of it has returned, but at a level I can tolerate.

Today I:

* Take a salt bath every morning.

* Keep my skin as moist as possible with just normal lotion or vaseline.

* Get moderate amounts of sun because it responds to UV light.

* Occasional use of a strong (prescribed) steriod cream.

Cold, dry weather makes it worse. You might check out:

www.psoriasis.org and look at some of the symptoms, etc. As well they have an active discussion board. Have your doctor check it. In Thai it's called saket neung ("silver coin") because in its most common form it can make circles that look like nickel coins or something.

Good luck. If you get to Chiang Mai I can reccomend my doctor; he's about the best in these parts.

[Jai Dee]

I just tripped over this thread too and thought I'd add my two satang...

Another very good cream widely available in Thai pharmacies is called BetaDipo. I play golf regularly, wear shorts and short socks, and quite often develop dry patches on my legs which become very itchy. Not sure if its a reaction to various grasses on the golf courses, or the water or soap you use when showering afterwards, but I've found that BetaDipo will not only alleviate the itchiness, but cause the dryness and subsequent inflammation to disappear within a couple of days.

Give it a try.

[Morbius]

Jomama, many thanks for your useful contribution. Psoriasis is something that none of the skin specialists I consulted ever mentioned to me. However, I think that I should look into this possibility as I might just be the victim of some misdiagnosis, too... By the way, I have noticed that my elbows have started to be affected too (but still very lightly).

A few questions, if you don't mind:

* How was psoriasis diagnosed in your case? Just by eye examination of your body? Or was some kind of skin test performed?

* Which normal lotion do you use exactly?

As I have explained in my previous postings, all the creams/lotions that I have tried to use (most of them being prescribed by a physician) have a temporary healing effect: they moisten the skin for about an hour, after which, once they have been absorbed, the skin discomfort comes back, and it is sometimes even worse. Have you experienced this, too? If you have, have you found any drugs/products that helped relieve the symptoms (and that you have not mentioned yet)?

[jomama]

Mobius,

Psoriasis has been around since ancient times (in Greek it means itchy skin) and has frustrated attempts by doctors and scientists since that time to find a cause and cure.

It is an auto-immune disorder similar to arthritis in which the body sees healthy cells -- in this case skin -- as being under attack and sends “fighter cells” to the “rescue.” With psoriasis this means a very rapid build up in skin production. The top-most layers then die off, forming scaly bulges that can flake, itch and be painful.

As I said, mine began on my index fingers. When it moved to the tips of my fingers they cracked in small fissures as if someone took a scalpel and made tiny cuts in the tips of my fingers. Very painful. It also got on to the palms of my hands as you mentioned. The area between my fingers where they join the hands seemed also very susceptible. As I said, it eventually took over almost my entire body.

In the emergency room, they ran test after test to see what it was, but were baffled. A previous diagnosis of a fungal infection was proven false, thankfully (that is a symptom of HIV). Finally a skin specialist was called and gave a preliminary diagnosis of psoriasis, which was confirmed by the best specialist in town.

If it is psoriasis keeping it moist with any lotion is very important so it doesn’t get too dry, crack and become painful or too itchy. You might try some over-the-counter cortisone cream (which is a steroid). Steroids help to suppress skin production, as does sunlight. There are special UV narrow-band lights that can bring about complete remission. The only one in Chiang Mai is at Suan Dok hospital, and it is fully booked all the time so I’ve never used it. I know there are a couple of these light boxes at hospitals in Bangkok.

If you do a google search on “UVB light”+ psoriasis, you will see several companies that sell these lights, some of them small just to deal with hands. Some people get it only on their hands -- I wasn’t that lucky.

One of the oldest treatments uses coal tar, which is a very complex organic compound that seems to bring about healing.

It is a vexing affliction -- the symptoms and treatments that work vary greatly from person to person.

While it is far more prevalent in white-skinned people, Asians do get it too. A good skin specialist in Thailand should be aware of this significant skin ailment and what to do.

Again, there's a good chance not what you have, but I would check it out.

Good luck.

Jomama

[Morbius]

Thaks again for your info, Jomama.

Well, at the moment, I am still trying to get a diagnosis of what I have, and, right now, I have been able to get a clear one from any doctor.

Meanwhile, I have tried a few other hand creams. None of them gives any good result.

[jackr]

Be very careful with steroid creams, especially Dermovate. While the only way to treat certain skin conditions, they severely thin the skin over time and if the doc has got it wrong, you're doing yourself damage for no reason. You need to see a specialist and then get a second opinion before trying all sorts of drugs on your hands etc. It could be the water or a number of other things but one thing's for sure, it's in Bangkok.

Being near the coast is about the best place to be. The salt in the sea and a combination of sun (vitamin D) and humidity is great for the skin. Anyway you can get a transfer?

Like the avatar btw. Forbidded Planet: Robby the Robot and Leslie Neilson et al.

[jomama]

Be very careful with steroid creams, especially Dermovate. While the only way to treat certain skin conditions, they severely thin the skin over time ...

<{POST_SNAPBACK}>

That's exacty right. In the case of psoriasis, one wants to diminish skin growth. But if that is not what you have, steriods will indeed "thin" your skin. Even I, who know what I have, use it sparingly, often going weeks with out using it. I was just suggesting putting a bit on the fingers and see if it responds.

[jackr]

Be very careful with steroid creams, especially Dermovate. While the only way to treat certain skin conditions, they severely thin the skin over time ...

That's exacty right. In the case of psoriasis, one wants to diminish skin growth. But if that is not what you have, steriods will indeed "thin" your skin. Even I, who know what I have, use it sparingly, often going weeks with out using it. I was just suggesting putting a bit on the fingers and see if it responds.

Don't worry, not knocking your spot on info at all, jomama; just relaying what I went through as a kid and young adult with eczma on my hands - caused by dryness, allergies from contact with oils later on etc - and never really knew the risks with the cream. Was prescribed betnovate for years and, although it did well in combatting the problem, I never used to wash the ends of my fingers after applying the cream. As there was no eczma on the ends of my fingers I didn't need it to be there. Anyway, even today the slightest scratch to the tips of my fingers and other parts of my hands and they'll tear open.

Living in los semi-permanently now and must say, it really is good for the health, largely due to the humidity in my case being asthmatic as well. No skin problems at all but have a mild beer problem, although I always had that one.

Cheers

[jomama]

Ironcially, the climate here is good for my skin condition. Humidty, and even sweat, help keep the skin from drying out too much. At one time I used just the "S" formula (that's what I called it):

* Sun

* Salt

* Sulfur (from the nearby hot springs).

I also had Sangthip (whiskey) as another "S" at one time to help deaden the pain, but had to give that up...drinking most definitely makes it worse.

[Morden]

I've only just spotted this thread while doing a search so I hope it's not too late to contribute.

During a couple of visits to LOS last year I developed hard, yellow, prickly pimples and my palms. Also my scalp became very dry and a red rash descended over my temples and forehead. This was especially disappointing because I had just gone through a long period of intensive treatment to bring an outbreak of psoriasis under control.

I felt that there was a link with BKK but I can't be sure because I also went to Isaan and the coast. LOS doctors gave me steroids which kept it at bay but I felt that it may return at any time.

It was quite a while later that it dawned on me what was going on. The previous outbreak of psoriasis happened about the time that I could not get my usual shampoo and started to use Dove and Simple. I hadn't considered this link before because I have suffered from psoriasis to some degree or other for many years; stupid of me really because Head and Shoulders once gave me serious grief. I changed to T/Gel and, bingo, problem gone.

Psoriasis, and probably other skin conditions, is aggravated by what the metabolism sees as a threat either from without the body or within. This is what I deduced:

The change of shampoo two years earlier caused a metabolic reaction that aggravated my psoriasis. Then I went to BKK which was hot and polluted. The combination of irritating shampoo, heat and sweat was too much and the scalp, face and hands reacted strongly. Why the hands? Well, they touch the shampoo and, maybe, a residue is left. That was an irritaion that the skin on my hands had been able to cope with. Then I wandered around BKK touching goodness knows what and getting sweaty at times.

The change to T/Gel seems to have done the trick. It's made for people who suffer with scalp problems. A good non-steroid cream for other parts is Dovonex.

Each sufferer will have a slightly different experience and react to different stimuli. However, exchanging information is always helpful because we need to keep trying different things. I shall now try salt in the bath (Sea water is a great skin healer) and go back to using coal tar soap - thanks for the tip.

[sua yai]

One aspect of these skin complaints that I didn't notice getting a mention is stress.

Years ago I started getting skin problems on my hands and ankles. It really got quite bad and the affected areas were easily lacerated leading to infections. The local hospital initially diagnosed psoriasis and I was prescribed medication as has been outlined already by others. Nothing was working, so I was referred to a dermatologist who came down from BKK every two weeks.

He took a quick look/see and immediately said it wasn't psoraiasis, but a type of excema. Naturally, I wanted to know what has caused it, but it's notoriously difficult to pin down. The doc did ask if I was under any pressure though. At the time, I was going through a very tricky time with my ex g/f, the bar we were running wasn't doing as well as expected and the hours were killing me, plus I was having problems with my property back home and that was my main source of income. All in all, not a great first year's introduction to living in Thailand.

Now, some 6 years later, I'm happily married, have sold the bar, I eat and sleep better and have cut back on my boozing.

Net result - no problems now at all.

I'm not saying that my, or anyone elses' complaints are brought on simply by worry, but I'm absolutely certain that in my case the situation was worsened by anxiety and dissolute living.

Just a thought.

[Morbius]

It's a while I had not checked this thread and I was surprised to see new replies, after all that time...

Many thanks for your input, Morden and Sua yai! I certainly do agree that, while we may have our own distinctive problems, we can also benefit from sharing the results of our different experiences.

Shampoo and soap are (at least) the 2 products we use on a daily basis and which we apply on our hands first. Good point! Now, for the shampoo, I have been using the same for the last 12 years, so I can probably eliminate it... As for the soap, it's a different story, since I have started to use it only after I arrived in Thailand, after discovering that the one I was using previously was not distributed here. Just to give it a try, I've made a change and I have just started to use another soap. Let's see...