Bubbles on fingers (not fluid filled)....what is this?

[Colleen13]

Hi all,

I am new to this board and hoping that there is someone out there who knows what I have or at least can relate if they have it too but don't yet know it's name. In my early 20's I started to get small bubbles on the front (palm side) and sometimes the sides of my fingers. It has never affected my palms or any other portion of my body. They usually start out as a tiny (1-2 mm) size white dot. Within hours they start to increase in size as if the skin is bubbling up. Usually once they reach the size of a nickle they either break open or start to peel off whether I do anything or not. Once the initial area is exposed the edges will dry and continue to peel off until a very large raw portion is exposed underneath. Sometimes I will lose only the first layer but other times I will continue with this process until my skin is red, raw, cracked, and bleeding. There is no discharge or fluid in these sores. No discoloration of the skin. They are not really blister like because the skin seems to be dead already once it bubbles. It just sheds off like a snake but in small patches. It's almost like rapid shedding of dead skin. Sometimes a finger will have one of these spots only and sometimes I can get two or three at a time that spread until they join which makes for a huge open sore area. There are times that I can't hold a pen to write, shake hands, or do regular daily living activities because I will have so many raw bleeding fingers that these things are too painful. They are also embarassing. When someone wants to shake your hand and you have raw bleeding fingers they recoil. I often find I have to make excuses to hide my hands.

I would say that the majority of this shedding happens on the pointer and middle fingers as well as the thumb. The ring and pinky will sometimes have this occur but the frequency is far less common and the degree that it occurs is far less involved. I never get to the point of cracks and bleeding on the ring and pinky fingers. It can occur on one hand or both when it happens. There seems to be no pattern to when this occurs or the number of fingers involved at a time. I used to think this was a chemical reaction to something (like an allergic reaction of sorts) but have been unable in 14 years to figure out anything that would cause this. I have changed homes, jobs, cleaners, skin products, avoided skin products, etc. It has never been connected with anything environmental that touches the skin.

When this occurs it usually comes on fairly quickly. I will have weeks of this kind of peeling and then it seems to go into some sort of remission for up to 4 months. There is no treatment that has decreased the symptoms and nothing I have figured out that speeds the process. I have resorted to putting Crazy Glue on my fingers if they get really red and sore. This was on the suggestion of a nurse friend and it seems to at least reduce the damage once a crack appears. Kind of like a liquid bandage.

Nobody else in my family has this. However we do have several autoimmune conditions. In the last 2 years I have started to develop other symptoms suggestive of autoimmune issues but nothing definitive and my doctor doesn't think the skin problem is related to my other symptoms because of the 12 or so year gap in their appearance.

I would love to hear peoples thoughts on this. My doctor is out of ideas and I'm tired of having red, scaly, bleeding, and sore fingers.

Thanks Colleen

[B. Lewis]

Hi and welcome to skincell.  Have you seen a dermatologist for this?  If not, you should.  It sounds a lot like what I have, Palmo-Plantar Pustular Psoriasis (PPPP, or PPP).  It's a rare form of Psoriasis.  Are the bubbles filled with pus?  Go to the PPP thread started by Calamity Jane and take a look at some ot the pictures.  B

[Colleen13]

Hi,

Thanks for the reply. No they are not filled with anything. No fluid or pus at all. Which is why they don't seem like a blister of any sort. It's almost like somehow the skin just starts lifting off of the layers underneath. I've wondered if it was a connective tissue disorder, but really have no idea. I would think if it was that then it shouldn't just be limited to my fingers, but honestly I don't have a clue. My current "bout" is almost over so I can't even really post photos. There really is no yellowing or other skin discoloration either. The skin that lifts up of course looks like dead skin with it's whitish appearance. The surrounding area stays exactly the same color it always is, and the raw skin underneath is of course red raw. Other than that there is nothing to suggest a problem. It truly is like my skin sheds at super speed by bubbling up. I've never met anyone who has this or who has even heard of it before.

You asked if I've been to a dermatologist. The simple answer is no. I have been to my family doctor several times. I had also asked my previous family doctor. Neither of them felt that it was a significant worry. I've been prescribed cortisone's and other creams which seem to only serve to help keep the skin around the wound soft and often I have felt it leads to further lifting of the skin to surrounding areas. In otherwords, the cracks might heal but it makes the overall problem bigger. I'm in Canada so I need a doctors referral to see a dermatologist. I feel kind of stuck. It's also harder because often by the time I get into see someone the skin has mostly healed and it can be months before the next round.

Colleen

[Murray Walker]

Hi Colleen,

I agree you should see a dermatologist.  Although you might get good suggestions on here, I'm not sure how useful they will be - certainly less so than getting an expert diagnosis.  If your GP is out of ideas he can't say no, though if he does you can just go privately, where you don't need the referral.  Sometimes GPs don't think skin conditions are serious problems, so if you're really bothered by this you'll have to make clear how significantly it affects you.

The thing it reminds me of is pompholyx/dishydrotic eczema.  You can search for pics online to compare.  I've only had a few major flare ups of this so I don't really know much about it.  In my case, I'm not sure the bumps ever really got to the size of a nickel and they might have been pus filled - though that wasn't obvious to me just from looking at it.  On the other hand (ho ho), the distribution, fissures and bubble-like description fit with my experience of pompholyx very well.  This condition can get intensely itchy, although I don't know if that is always the case.

The usual treatment is to avoid triggers, especially hot water, and to use steroid creams for flare ups.  The hands can be hard areas to treat, so I needed the most potent steroid creams going to get this under control.  But avoiding the triggers has kept it at bay for about 2 years now.

Well, that's my suggestion.  I've no idea if it's correct or not so you definitely ought to tell your GP if you don't think you're being treated adequately.  Best thing would be to see a dermatologist.

Cheers,
Graham.

[Colleen13]

Thanks. I already have an appointment to see my doc next week because I've had a flare up of my other symptoms that also don't have a diagnosis. As I think I said in the first post I'm not sure if they are all connected to each other somehow. Possibly the skin was the first sign and as the condition (whatever it is) progresses other parts of the body become involved. If my fingers are still crazy by the appointment I'll have her look at them again. A friend who is a doctor (but not GP or dermatologist) suggested I try a naturapath. I figure it can't hurt so I'll also go that route to see what they come up with.

In the mean time I'll read more about the condition you mentioned too. Maybe it presents differently in different people. Thanks again.

Colleen