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Pauline
Pauline, Doctor (MD)
Category: Health
Satisfied Customers: 8631
Experience:  Medical Doctor & Registered Pharmacist. Worked as Community pharmacist for 17 years.
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Hello. I have 3 brownish raised bumps (less than 1 mm) on my

Resolved Question:

Hello. I have 3 brownish raised bumps (less than 1 mm) on my right hand. The bumps are in a cluster (looks like a V) and has a red backround around it. The area is slightly painful (maybe a 1 on the 1-10 scale when direct pressure is applied, but only when pressure is applied), no burning, or tingling, it has been slightly itchy. Onset was 4-5 days ago when it presented as a slightly painful red mark (I thought it was a "hot spot" that you get before a blister since I noticed it after working out), about 3-4 mm and day by day it evoled into what it is now. The only change that was made was that day I wore a pair of gloves that I haven't worn since last winter. I have been treating with a 2X2 and Clotrimazole Cream 1% which has relieved the itching and some of the reddness around the bumps but not the bumps themselves. I also tried Hydrocortisone 1% but there was no change so I D/C'd the treatment and have been sticking with the Clotrimazole Cream 1%. I have afew days before I can go see my doctor and I have been google searching everything, from Eczema to Shingles. I'm hoping a R/O shingles for obvious reasons but have not been able to because I have conflicting D/Xs. The spots are not located on a dermatome line (inbetween index and middle finger about 1 inch down), no burning sensation, the spots are localized and do not spread, the bumps are not leaking and fluid and no crusts have formed. But I'll be damned if they dont look like the pictures I have seen of Shingles. I was also thinking maybe some sort of bacterial infection because of the gloves I dug out of my closet the day of, but I really have no idea. I hope I have included enough information for you a make an informed D/X. I am a Combat Medic in the Army so I specialize in Trauma and admittedly my weak area is dermatology. So I'm leaving this up to the pros. Thank you very much for this service.
Submitted: 3 years ago.
Category: Health
Expert:  Pauline replied 3 years ago.

Pauline :

Hello, would you be able to post a close up photograph?

Customer :

Yes just let me try to figure this camera out

Customer :

Full Size Image

Customer :

Full Size Image

Customer :

as you can see, the redness isn't as severe as it was before applying the Clotrimazole Cream

Customer :

Are these pictures good or do I need to try to get better ones?\

Pauline :

Thanks for the photo. Its obviously not as good as examining in person but this looks similar to a pomphylox type eczema. Do you have any lesions anywhere else?

Customer :

None. Belive me I have looked. Once I found out that it might be Hepres Zoster, I. Looked. Everywhere.

Customer :

What are the S/S of pomphyylox eczema? What could have caused it?

Pauline :

This can occur for a number of reasons...reaction to chemicals, metal is a common but sometimes we just don't know. Here is a info pahe with some self-care advice that may be usefule: here

Pauline :

I would continue with the hydrocortisone or a stronger steroid if you have access.

Customer :

Thank you. From what you've seen would it be safe to R/O Shingles?

Pauline :

It doesn't look like early shingles. And it would be a unusual place to get an isolated herepes lesion. The only other possible diagnosis that crossed my mind was hand, foot and mouth disease....so if you get any blisters on feet or mouth ulcers then this needs to be ruled out.

Pauline :

sorry about the spelling!

Customer :

Understood, I am will going to the doctor as soon as the hospital opens back up. I will not bother the ER with this nonsence. What is the difference between Hydrocortisone and Clotrimazole? Like I said, I'm a Trauma specialist, dermatology is my weak area.

Customer :

Dont worry about the spelling, I have the double check everything I type

Pauline :

Hydrocortisone is a mild steroid while clotrimazole is a anti-fungal. So although it is possible to get pompholyx with athletes foot..in this case I do not think the clotrimazole is needed.

Customer :

Ok. As of right now the only thing I can get right now OTC is the hydrocortisone. I am stationed in Germany right now, and the Germans dont really have anything like a Walgreens. I sucks. Is ???pompholyx eczema contagious? I have been keeping it covered 24\7 with a 2X2, and changing them out Q6H but I was wondering if I needed to keep it covered all the time.

Pauline :

I would not cover it unless the blisters start to weep. But if you are doing a task that may introduce infection then at least wear gloves. It is not contagious but may spread.

Pauline :

However if this was hand, foot and mouth..then this is contagious.

Customer :

Can you give me some S/S on Hand foot and mouth before I leave you alone?

Pauline :

Sure....this is another info page from the same site...I use it a lot for patients. Here . You do not mention any signs of being systemically unwell so I do not think it is H, F and M but it needs to be considered if you were to be unwell.

Customer :

?Roger. Thanks a million doc! I'll still go see my Doctor on Tuesday but you have relieved most of my stress about this issue until I see him. I'll continue to look this stuff up on my own time. I was not feeling unwell at all, my wife had a cold, and is getting over it, I think she caught it from me a while ago but it didn't stop me from doing anything. Thanks again! I'll check this stuff out.

Pauline :

Glad that this has been helpful.

Customer :

One the H,F,M site you just gave me, the sore on the mouth look like cold sores.\

Pauline :

Yes, the appearance of the blisters in H, F and M varies between the skin and the mouth. However the blisters on the hands and feet can be clear or grey blisters on a red base, I have seen a few cases over the years. Although usually children.

Customer :

OK. The common age (from the site you gave me) tended to be in children, while Shingles tended to be in older people. My PA would tell us when we had a problem with a DX that "You guys are just medics, so your scope of practice will only let you have 2 or 3 possible solutions. I'm a PA so I can think of about 10 or 15, a Doctor can think of about 20." I could only think of Ezcema and Shingles.

Pauline :

My feeling is that this is eczema and possibly related to a combination of sweat, friction and metal handles from the gym equipment unless you have been using other chemicals in your job.

Customer :

Just the weight bar in the gym. The day before it popped up, I just started using a Kettle Bell in my workout. It could explain it but I used both hands, the bumps are only on one hand, does that even matter?

Customer :

But during the workout I was sweating like the devil in a church.

Pauline :

Unfortunately sometimes these things are hard to pin down..but may be worth using exercise gloves in the future.

Customer :

Consider it done. Thanks again doc. I'll let you get back and stop bugging you.

Pauline :

Thanks for using Just Answer...hope you have a peaceful new year!

Customer :

Ha! Same to you, it will be peaceful unless I head back to Afghanistan for round 4. Take it easy.

Pauline, Doctor (MD)
Category: Health
Satisfied Customers: 8631
Experience: Medical Doctor & Registered Pharmacist. Worked as Community pharmacist for 17 years.
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