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khagihara, Medical doctor
Category: Dermatology
Satisfied Customers: 6403
Experience:  Trained in the multiple medical fields for many years.
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About 9 weeks ago, I dropped of my son's friend at his

Customer Question

About 9 weeks ago, I dropped of my son's friend at his house. As I spoke with the the friends dad, a lot of dog hair landed on my pants, which I brushed off. When I got to my car, I rubbed my palms together, and by the time I got home, my hands palms were red and stinging in the area I rubbed. Since then, it has moved to the tips of my fingers. I've gone to a dermatologist who prescribed a strong, topical steroid cream. This didn't work. I should also note that about 4-5 days later, my fingers and palms began to sweat, leaving my fingers pruney at times. The symptoms have ebbed and flowed, but never gone away. Working with my hands seems to exasperate the condition, which if that happens, takes a week to "settle down." Again, it never goes away. When I wake up, the joints in my fingers can slightly ache but goes away after about 10 minutes. I have had addison's disease for 19 years and for the last three have worn compression socks due to venous insufficiency. At this time, I also became gluten sensitive, but do not have celiac disease. My endocrinologist says this isn't related to addison's, and the dermatologist doesn't know what it might be. Any thoughts would be appreciated...thanks!
JA: How long have you had the symptoms? What seems to make the symptoms worse or better?
Customer: As I stated, 9 weeks...working with my hands makes the symptoms worse, like turning a screw driver, vacuuming, moving luggage around, etc.
JA: Anything else in your medical history you think the doctor should know?
Customer: Addison't disease, venous insufficiency, gluten sensitive
Submitted: 2 months ago.
Category: Dermatology
Expert:  khagihara replied 2 months ago.

I will try to help you. Can you attach the photos here? Itch or pain? Does anything make it better or worse? What tests did you have with your dermatologist? How old are you? Are you a male of a female? How tall are you? How much do you weigh? Any weight change? Any other symptoms? Are you aware of anything which might have triggered it besides the dog hair? Any other medical problems? Any surgeries? Any medications including over-the-counter pills and herbs? Any family medical history?

Customer: replied 2 months ago.
dd first two pictures were taken a few days after it happened. Pictures three and four were taken 6-7 weeks after.There is stinging that comes and goes in the red part. When I'm in the shower, they seem to feel better. No tests from the dermatologist, but she had me on halog cream for three weeks with no effect. I am male 5'5" 135lbs. No weight change. Other symptoms are the occasional perspiration on my hands and fingers that cause my fingers to become pruney. No other medical issues than what I stated (Addison's disease, venous insufficiency, gluten sensitivity). I take 20 mg's of cortef daily for addison's and .05mg fludrocort. Appendix taken out 14 years ago. No herbs, no family history.Outside of the occasional stinging, which again, comes and goes on the red part only, I would have to say that overall my palms "don't feel right." (It's difficult to articulate the sensation, but gripping things (steering wheel, vacuum cleaner, door knob, etc.) is something I have to be careful doing or I can create pain). All though the pics don't show it, by entire palm can become blotchy red with various intensities. I'm wondering if I have a vascular issue, but realize that what triggered it was rubbing my hands together in the car after leaving the house that had the dog hair. I'm not saying it was the dog hair that caused it, I just know that within 15 minutes of doing so, I had stinging and red in the areas the pics show.
Expert:  khagihara replied 2 months ago.

It seems to be palmar erythema.

Causes of secondary palmar erythema include:

  • Liver disease: cirrhosis (23% of people with liver cirrhosis develop palmar erythema), Wilson disease, hemohromatosis
  • Endocrine/nutritional: 18% of people with thyrotoxicosis and 4% of people with diabetes develop palmar erythema
  • Autoimmune diseases: over 60% of people with rheumatoid arthritis develop palmar erythema
  • Drug-induced palmar erythema: drugs include topiramate and salbutamol if the liver is functioning normally, or amiodarone, cholestyramine and gemfibrozil if there is liver impairment
  • Other: including infection, atopic dermatitis, primary or metastatic brain cancer, smoking and chronic obstructive lung disease

You sould have the following test as well as a skin biopsy.

  • Complete blood count
  • Liver function and blood urea nitrogen/creatinine
  • Hepatitis B and C virus serology
  • Ferritin
  • Fasting glucose
  • Thyroid stimulating hormone
  • Chest x-ray

In addition to these tests, you may have ceruloplasmin, proalbumin, albumin, rheumatoid factor, Cyclic Citrullinated Peptide Antibodies (CCPA), ANA, SSA, SSB, MRI brain, CT chest/abdomen/pelvis or a bone marrow biopsy if necessary.

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