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Thank you for the photograph. My first possibility would have been Tinea Manum, which is a fungal infection of the hand, however the lack of significant itching precludes this. The next possibility would have been Keratolysis Exfoliatava, which is like seasonal moulting of the skin of the hands, but the fact that only one hand is affected and you have had symptoms for 9 months again rules this out. Contact Allergic or Irritant dermatitis
do not fit into your history. Which leaves us with Palmar Psoriasis. In atypical cases like yours a skin biopsy is usually required to confirm the diagnosis. However another option is to treat for Psoriasis and see if there is any improvement - which will confirm the diagnosis.Here is a regimen I would recommend for this:
1. Cortizone cream
+ Mg 217 sal-acid ointment
twice a day (morning & evening) over all affected areas. Mix these two creams in equal proportion before applying.
2. Triton Mg 217 intensive strength medicated tar ointment
: apply over skin lesions once at night. Wash off in the morning. Can stain clothing so appropriate precautions should be taken.
3. Balnetar Therapeutic Tar Bath
: Add to tub of water as directed on the bottle - soak hands in tub for 15-20 minutes. If this is not possible then use soapworks coal tar soap bar
and leave lather on for 5 minutes. Product does not smell very good and will stain clothing but is effective.
4. Omega-3 fatty acid
capsules - 2 in the morning & 2 at night after meals for 4 weeks and then one capsule twice a day thereafter. Use this only if you have no heart problems.
6. Olive oil or Neutrogena body oil massage on the affected hand once a day. This is optional.
NOTE: All of these are available over the counter without a prescription & online at amazon.com
. Treatment will need to be continued for 2-3 months for maximum benefit.
Hope this information is useful, please feel free to ask if you have any queries.