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Dr Uzair
Dr Uzair, Doctor
Category: Dermatology
Satisfied Customers: 6731
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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Past 3-4 years, I get pinpoint vesicular lesions in clusters

Customer Question

For the past 3-4 years, I get pinpoint vesicular lesions in clusters on my hands. They are often near my fingernails or on my palms. They appear suddenly in small clusters bilaterally, they do not itchy or cause pain typically other than a little burning intermittently. They come under times of stress and resolve typically in 1-2 weeks. I always assumed they were just flat warts, but I'm wondering if the quick resolution suggests an alternative diagnosis.
Submitted: 9 months ago.
Category: Dermatology
Expert:  Dr Uzair replied 9 months ago.

Hi and welcome.

From the signs and symptoms you described it seems like an allergic problem. I would suggest you to see a dermatologist when you have active lesions on skin for exact diagnosis. An allergy to a particular food can cause such type of reaction which is self limiting most of the times.

Expert:  Dr Uzair replied 9 months ago.

Let me know if you have further questions.

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Wish you good health.

Customer: replied 9 months ago.
Could you please offer a little broader differential and provide the rationale. I would think that allergic would be more pruritic and possibly erythematous. My pinpoint vesicular lesions are clustered on a non-eryrthematous base without pain or itch. The come in waves over a 2-3 week period in a synchronous pattern (one set of clusters goes away and another pops up etc). FYI I'm a 4th year medical student so please don't be afraid to speak technically.
Expert:  Dr Uzair replied 9 months ago.

Thanks for the reply.

A picture would have been really helpful here. But if you want to consider a broader differential, then warts are one, psoriasis vulgaris is another, acute vesiculobullous hand eczema (Pompholyx) can also be a cause.

The definitive diagnosis can be made on clinical evaluation and the treatment depends on the underlying cause. Warts are usually cauterized, eczema and psoriasis are resolved generally on application of topical steroids and avoidance of the trigger.

Expert:  Dr Uzair replied 9 months ago.

Let me know if you have further questions.

Please do not forget to leave a positive rating by clicking on stars on top right corner.

Wish you good health.