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What causes the following: very painful, hard bumps to form…

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What causes the following: very painful...
What causes the following:
very painful, hard bumps to form on hands, especially fingers. So painful, hard to move fingers. They also itch and sometimes have clear fluid. I associate the reaction to either heat or sun as that is when it occurs. Pain is relieved by emercing hands in ice cold water. Can take several days to clear. I tend to be very sensitive to sun and heat.
Submitted: 8 years ago.Category: Dermatology
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Answered in 16 hours by:
6/27/2010
Dermatologist: Dermadoc, Board Certified Dermatologist replied 8 years ago
Dermadoc
Dermadoc, Board Certified Dermatologist
Category: Dermatology
Satisfied Customers: 2,404
Experience: MBBS, DNB DERMATOLOGY
Verified

hello,

it will be better to see the photos and diagnose your condition. would it be possible for you to post them here through amazonaws.com or picasa?

you can also give me information on the size, shape,color of the lesions? Whether they are flat or raised? how do they start? where did they first start? how did it progress? any fluid filled or pus filled lesions? did you take any medications for it? are you on any other medications?

If you cannot send me photos, please do let me know.

Regards.

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Customer reply replied 8 years ago

I dont have pictures. Sorry. They resemble either hard lumps under the skin sometimes red or in the worst case 3rd-degree burn blisters filled with liquid but not puss. they start as an itchy bump under the skin that becomes raised. they are visible (almost knot-like under the skin) but unless I have irriatated them by scratching they are red. the reaction is inconsistent. I dont take meds for them. they start small - pinhead-size but can get very large as blisters. if i open them from scratching, they itch all the more.

i stay out of the sun because I react quickly to it. sometimes the reaction happens from sun exposure, sometimes heat will initiate the reaction. Generally it starts on my hands and can spread to other areas - limbs, it I dont stay covered up.

i have never been able to get into a dermotologist quick enough from them to see what they took like. The wait time is enought to allow them to disappear.

Sorry I cant be more help. I feel them coming on. I am at a children's camp we run in NC where the heat is in the 90's. If i protect my hands and try to stay cool, i can help stave them off.

Dermatologist: Dermadoc, Board Certified Dermatologist replied 8 years ago
hello,

i would like to know a few more things:-

1. when they disappear, what is the sequence of events in which they disappear:- do they leave open sores, scars or pigmentation?

2. are these lesions only in sun exposed parts or also in the covered areas?

3. do the lesions come and go on their own and in how many days?

4. do the blisters always start on the hands? or even on the face , neck, forearms?

please let me know.

regards
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Customer reply replied 8 years ago

1. When they disappear they do not leave open sores unless I have scratched them. Generally they slow disappear...the itch first, then the lump.

2. the do appear to only start in sun exposed areas of the skin.

3. they do come and go on their own. they may be several months or weeks between outbreaks. it generally takes them several days to go away.

4. I feel the irritation in my hands the most and first. but if my shoulders are exposed i will get the same bumps. I can recall them ever being on my face or neck, but have had them on my forearms to the point of covering my hands and arms with socks to protect them from the sun.

It is hot here and I am feeling like they are trying to crop up. My hands itch and my fingers feel stiff and puffy but no bumps yet. If they do I can try to take a picture.

The outbreak is inconsistent. I can sometimes be in the sun and do fine...other times they crop up quickly. 15 minutes in the sun and I have heat exhaustion or a pink sunburn that makes me miserable.

Dermatologist: Dermadoc, Board Certified Dermatologist replied 8 years ago
hello,

without seeing the photos, its difficult to diagnose it, but i can give you a differential diagnosis:-

1. solar urticaria

2. photocontact dermatitis to some topical medication applied.

3. photoallergic dermatitis to some medication being taken orally.

4. porphyrias

5. connective tissue disease like acute lupus erythematosus.

6. vesiculobullous disease like epidermolysis bullosa acquisita.

you have few features seen in these disease but not all.

in dermatology, we need to see the lesions to come to a final diagnosis, till then the diagnosis is most probable.

you can send me your photos if possible or you need to visit a dermatologist and you could discuss my suggestions with him. post them here through amazonaws.com or picasa.

please feel free to ask me in case you have any queries.

regards

Dermadoc
Dermadoc, Board Certified Dermatologist
Category: Dermatology
Satisfied Customers: 2,404
Experience: MBBS, DNB DERMATOLOGY
Verified
Dermadoc and 87 other Dermatology Specialists are ready to help you
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Customer reply replied 8 years ago

Thnka you. It is a start. And some of these conditions can be associated with celiac disease.

When the erruptions occur I will be back in touch.

Cynthia Kupper, RD

Exec Director

Gluten Intolerance Group of NA

www.gluten.net

Dermatologist: Dermadoc, Board Certified Dermatologist replied 8 years ago
please do so. you are welcome
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