Author Topic: help for a newbie - pompholyx - does anyone recognise this series of events?  (Read 6813 times)

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Offline beetle

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Hello!

I wonder if anyone can help me. I'm currently suffering from an outrageous attack of pompholyx all over my fingers, palms, slightly onto my inner wrists and, very worryingly, my heels.

I have had very mild pompholyx since I was a teenager (now 38) just on the sides of my index fingers, middle fingers and inner thumbs and only for a few weeks in the summer. It was slightly annoying, could be quite itchy and my fingers never looked great but it never bothered me too much.

Anyway, in August I caught athlete's foot from a public pool (I had taped up a toe as I thought I had a verruca on it and the tape had made the skin a bit raw). Having never had athlete's foot before I initially thought it was an insect bite, then I thought it was a reaction to the verruca treatment I was using. Finally, 10 days ago I went to the doc who said it probably was tinea pedis (athlete's foot) and gave me anti fungal cream (terbafine) to put on it.

I started using the cream and within 24h I noticed a few tiny pompholyx blisters appearing on my fingers - weird, I thought, I've never had this in winter before. 2 days later my fingers and palms were COVERED. Like I have never seen before. The itch, as you all know, is unbearable and I haven't slept properly for about a week  :'( The little blisters have all merged to make a few huge ones and I can't even hold a pen (luckily I can type though  ;))

I also developed, at exactly the same time, a horrible, angry rash on my chest and neck that looks and feels just like "prickly heat" (or maybe like regular eczema, I'm not sure as I've never had it).

I can't believe all these itchy things are unrelated and having done some research it seems that pompholyx can occur as a result of a fungal infection at a distant site (in my case, a toe!). But I don't understand why the pomp only appeared when I started using the anti fungal cream. I mean I had had the infection for a good few weeks before that with no outbreak of pompholyx.

Could it be an allergic reaction to the anti fungal? I also started taking an antihistamine at the same time and wondered if it could be an allergic reaction to that????

If you've read this far, thank you! If you can shed any light I will be so grateful....I'm going a little mad here.

Beetle x
« Last Edit: Friday November 01, 2013, 12:33:39 PM by beetle »

Offline salvanost

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #1 on: Wednesday November 06, 2013, 02:01:20 AM »
no, i don't think it's from the anti histamine
because i got so much anti histamine from my pomp treatment
and using it to help my sleep problem (after my pomp recovered)

in the past my doc gave me the anti fungal med

but at that time my pompholyx already at worst stage
both hand and feet got so much blister
i cannot say the anti fungal bad for my condition, i'm not research the anti fungal,
at that time my focus was to collect all information about effective med and blame the worsened condition on other trigger exclude the medicine

but i can say the anti fungal not working on my situation
i toke that decision after use anti fungal for almost 3 weeks

that's why i decide to stop using the anti fungal and focus on trigger

Offline beetle

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #2 on: Wednesday November 06, 2013, 07:50:46 PM »
Hi Salvanost,

Thanks so much for the reply : )
I think you're right, it wasn't a reaction to the antihistamine or the anti fungal (although I did swap from the terbinafine to miconazole just in case!).

I was going soooo crazy I did a ton of research and I discovered that my outbreak of pompholyx (and the weird itchy rash on my chest) was probably a dermatophytid reaction (also known as an "id" reaction) to the fungal infection (athlete's foot - tinea pedis) I had on my toe!! I really hope that the following info will help somebody.

"A dermatophytid reaction is the body's reaction to a dermatophyte (fungal) infection and is a skin eruption that appears on an area of the body that is not the area where the infection first began.
A fungal infection on one area of the body can cause a skin eruption to appear on another area of the body that is not infected. For example, a fungal infection on the foot may cause an itchy, bumpy rash to appear on the fingers. These eruptions (dermatophytids, or identity or id reactions) are allergic reactions to the fungus. They do not result from touching the infected area. The eruptions may appear on many different areas of the body at once.
The eruptions are typically itchy. They may take various forms, for example, small, fluid-filled spots (on the hands or feet); solid bumps; red, raised patches; deep, raised, bruiselike areas on the shins; pinkish red spots that resemble targets; or hives.
The dermatophytid reaction goes away once the dermatophyte infection has been cured. To relieve symptoms, doctors give corticosteroid creams, anti-itch drugs taken by mouth (such as hydroxyzine), or both."

I also found this very interesting research paper on the need for doctors to recognise the signs of a dermatophytid reaction and not confuse it with an allergic reaction to anti fungal medication. It's based on research of children with fungal infections on their heads, but is relevant to adults with fungal infections elsewhere too. http://pediatrics.aappublications.org/content/128/2/e453.full

If you can't be bothered to read it  ;) it essentially says that too often people stop using their antifungals because they think they are causing the rash, when actually, the only thing that will stop the rash is to continue with the antifungals to eliminate the fungal infection! (Antifungals can, in very rare cases, cause skin rashes, but much more frequently it is the fungal infection that is the cause).

This info is obviously relevant to me and I'm not at all assuming that it will help everyone with pompholyx as I understand that there can be many triggers. However, if you get a sudden outbreak, out of the blue, and it coincides with a fungal infection elsewhere on you body, this might be your answer : ))

As for me, the pompholyx is slowly drying up and I'm getting fewer new blisters everyday. The itch has abated somewhat (although I still have to go around with a small cooler bag full of ice packs!). My athlete's foot is also improving after two weeks of topical anti fungal treatment. I spoke to a podiatrist who told me that it can take up to 4 weeks for it to completely go (and to continue with the cream for a good few weeks after that!) and if not, then to try a different anti fungal agent.
My own research has scared me too much (the beauty and the curse of google  :)) to take an oral antifungal although I understand that they can be very effective and, if used for short periods (ie 2 ish weeks for a skin infection rather than 6 ish months for a nail infection), do not pose too much of a risk!

Salvanost, I really hope you find your trigger. It might be worth sticking with the antifungals just for a bit longer, bearing in mind how long it can take to get rid of the fungus. Let me know how you are getting on.

If I find any more info, I'll post it here, just in case it helps anyone else : )

Beetle (slightly less itchy and irritable now!)

Offline beetle

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #3 on: Thursday November 07, 2013, 09:25:21 AM »
PS Copious amounts of red wine is not an effective coping mechanism for pompholyx.
SOURCE: personal experience : )

Offline Carwin

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #4 on: Monday December 16, 2013, 09:33:26 AM »
I started getting pomphylox for the first time a few months ago, in my 40s, and read about the link to athlete's foot/fungal infections, and as I'd got athletes' foot also for pretty well the first time ever, I assumed that was what caused it. Mine came on a week or so after I'd started putting anti fungal cream on my feet, and I was worried at first that the fungal infection had spread to my hands. I spoke to the pharmacist who gave me a steroid cream, and it went after a week or so.

I seem to be stuck with it now though, the steroid cream makes it go and then it comes back a week or so later, and the athlete's foot is long gone - I'm wondering if there is another trigger or if it's just that you're stuck with it once something has set it off? Nothing else has changed that I can think of :(

Offline chelseygunn

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #5 on: Monday December 16, 2013, 10:03:55 AM »
for the past month ive had severe pompholyx eczema, i did think it was clearing up until it started to come back, since ive got it, ive been so careful on what products i use, and ive wore gloves when ive had to touch anything with fragrance in or alcohol in (if i remember). but i started a new job in boots on the 1st of november so im thinking that it could be something to do with something ive touched while ive been at work.

ive done tons and tons of research but i dont feel as though im any closer to finding out whats causing the problem.

what im wondering is, what are the allergic reactions people have been diagnosed with? im getting an apointment with a dermatologist, but that could take several weeks.

its driving me crazyyy!

Offline smokytopaz

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #6 on: Saturday December 21, 2013, 11:25:04 PM »
It is possibly not pompholyx but severe contact allergy dermatitis...... and the biggest new contact allergen is Isothiazolinone, Methylisothiazolinone and Chloroisothiazolinone - check it out - google it. Its a newish preservative in shampoo and all sorts of products, they took out parabens and used this instead starting in about 2005, and once you get sensitized tis a devil to pinpoint. I eventually found it (after three years!! :)) and now my hands are 95% clear and my feet are about 80%. Sadly it will take up to a year before my skin settles down, but it will only settle down if I never ever touch these chemicals again. And everything else I have ever reacted to is so much more liable to flash again.
The dermatologist may not be aware but they do do patch testing for this.

Offline hopefullyoptimistic

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #7 on: Tuesday January 14, 2014, 08:14:40 AM »
Hello, I am new to this blog, and after much research the past few days I finally figured out my condition. I have a severe case of pompholyx that I was convinced was dyshidrosis and eczema.  And like you I came down with my first nasty bout with athletes foot. I used a liquid anti fungal spray for just a few days and stopped suddenly after thinking it had subsided. It did not and last evening it flared up dramatically. I was working and after my shift found an abundance of tiny patches of blisters spread all over my feet, hands, elbows and a few other places. I popped a few and suffered the consequences. I have purchased lamisil for the athletes foot and 1% hydrocortisone cream for pompholyx.  After reading your post I'm relieved to learn it's not an allergic reaction to the anti fungal cream. I will make sure to get my athletes foot cured. Thanks. Any other help or remedies are welcomed

Offline Bamawing

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #8 on: Tuesday January 14, 2014, 06:48:02 PM »
The thing with pompholyx is it can be triggered by things like athlete's foot. Even after you take care of the fungus, the pomplolyx can pop up.

I use apple cider vinegar for mine - just soak the itchy digits in the stuff for a couple of days until they feel better.
I'm more confused than a mood ring on a paranoid bipolar schizophrenic chameleon in a bag of skittles!

Offline hopefullyoptimistic

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #9 on: Wednesday January 15, 2014, 12:25:06 AM »
Obviously it seems as though I'm stuck with it. But will the blisters subside and at least give my hands an appearance of normalcy? This is just my third day after a pretty nice outbreak? The itch only bothers my during sleep. I guess the creams dry or rub off. I go back to work tomorrow. I wear rubber chef shoes with little ventilation and just bought socks with a "dry" feature. My hands are only noticeable upon close inspection. It seems my athlete's foot flares up at work.what can i do for work where managing this condition is tough? Thanks for the help

Offline Bamawing

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Re: help for a newbie - pompholyx - does anyone recognise this series of events?
« Reply #10 on: Wednesday January 15, 2014, 04:05:11 PM »
My skin is worse at night because I'm under blankets. Heat = bad for this stuff. If I can manage to sleep with my hands outside the covers, I do better... and the one time it was on my toes was the worst.

Socks with the dry feature sound like a good idea. Only other thing I can offer is to take breaks and give them some air. Heat really is the enemy... cold relieves itch. When it's so bad I have to scratch, I make it a point to scratch with an ice cube. (Again, this is a lot easier because it's on my fingers.)

Best of luck to you. :( On the feet is the worst ever!
I'm more confused than a mood ring on a paranoid bipolar schizophrenic chameleon in a bag of skittles!