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I was diagnosed with a periungal wart on my left thumb which…

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I was diagnosed with a...
I was diagnosed with a periungal wart on my left thumb which was immediately treated with cryotherapy. Pain extending from the treated area to the tip of my index finger was immediate and lasted for 2 days. The area where the wart was and approximately 3 cm below my thumb were initially affected. The "wart" initially was white, then red, then white again as the area below my thumb nail. These areas became necrotic and I shaved them off a few days later. I continue to have pain in this thumb as well as an overgrowth of shiny, thick, skin the entire length of my thumb which now is traveling to my hand. I have been treated with antifungal that seemed like it was working but no longer does. When my thumb is wet the skin turns white and soft but rapidly dries to its previous state. I can shave all the skin off daily but 2 days later you cannot tell it did anything to it. I have been seeking an answer since 2/2010. My PCP does not know what it is and has no suggestions. I am an ICU RN and this is a constant concern.
Submitted: 8 years ago.Category: Dermatology
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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 important for me to see a photo of the condition that you are mentioning.

please could you send it to me?

you could use picasa and then send me the link.

i will be able to tell you what exactly do you have after seeing them.

thanks.

regards
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Customer reply replied 8 years ago
These are the photos you requested. Unfortunately, I have been digging holes in the skin to permit freedom of movement and to feel air. Additionally, when the thumb is coated it looks like a thick glove and is so slick I have trouble holding objects. The sensation when I peel the skin off is prickly but definately deminished. When encased in the overgrowth of skin I experience numbness and tingling in the area. The only other significant information I can think of is that the area immediately distal to my thumb is most tender with a muscle-type pain.



I don't know why this photo is this big but the white lines are from Tinactin powder which is the only thing that soothes the pain.


The following pics are after soaking in water. If I my hand is wet from water or in gloves for 5 minutes it turns very white.
Dermatologist: Dermadoc, Board Certified Dermatologist replied 8 years ago
hello,

there are three conditions which it could be:-

1. allergic contact dermatitis.

2. pompholyx

3. tinea manuum

its more likely the first one.

barrier creams work well in preventing contact dermatitis, however, it will be better to wear a pair of cotton or plastic gloves before you wear the latex ones.

also it will help to change the brand of soap you are allergic to, sometimes doing that helps.

also you need to apply desonide cream twice a day for 15 days.

also you can try using tacrolimus cream once a day to the affected areas.

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

hope this answer was useful. please click on the green accept button if so. any bonus or positive feedback would be appreciated.



you could be allergic to either latex gloves or soap.
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Customer reply replied 8 years ago
I am allergic to latex and avoid contact with it at all cost. Further I have changed soap nor has the hospital soap been changed. This started in February at the area of the wart and below the thumb nail. If you compare the photo of my affected thumb with the photo of my non-affected thumb you will note that I have lost approximately 2mm tissue from my left thumb. There is no cuticle remaining. Also, the spread has been gradual but constant. When I have shaved off the overgrown tissue while wet the skin looks normal, However, within the hour the tissue turns angry red, shrivels, and burns like fire for a couple of days untiil a new coating encases it. It usually takes 2-3 days for the new glove-like covering to form leaving no trace that I removed it.
Dermatologist: Dermadoc, Board Certified Dermatologist replied 8 years ago
hello,

thanks for the information.

i highly value it.

but its surely not due to a wart now.

its the allergy which has aggravated with an additional factor of pompholyx which is an eczema.

you can try the treatment i have advised and see if it helps you out.

i am sure it will.

please let me know if you have any more queries. will be happy to help you.

regards
Dermadoc
Dermadoc, Board Certified Dermatologist
Category: Dermatology
Satisfied Customers: 2,404
Experience: MBBS, DNB DERMATOLOGY
Verified
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Customer reply replied 8 years ago
I never thought it was a wart but something possibly triggered by the cryotherapy. The information and photos of pompholyx most closely explain the symptoms I present with. I also noted that methotrexate is listed as a treatment. I have taken that in the past for RA. Further, I definately fit the stress bill as an night-shift ICU RN. Thank you for your help, I will present this info to my PCP.
Dermatologist: Dermadoc, Board Certified Dermatologist replied 8 years ago
you are welcome
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