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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9190
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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I have a sore tip of my little finger on my left hand. It is

Customer Question

I have a sore tip of my little finger on my left hand. It is inflamed and flaky slightly burning and I feel like the skin is going to explode because it is that hard. I have been prescribed fungal tablets, caneston HC, and most lately Fucibet cream but it seems to be getting worse and spreading further down my finger and lifting my nail off. I have had this for nearly 3 months
Submitted: 6 years ago.
Category: Dermatology
Expert:  Dr. Nair replied 6 years ago.

Can you take a photograph of the little finger?
Customer: replied 6 years ago.


Here are Pictures, I hope you can help?graphicgraphicgraphic

Expert:  Dr. Nair replied 6 years ago.
Thank you for the photographs. Tell me do you get any pus filled lesions near the nail folds or on the tip of the finger?

If I may ask what is your line of work? Is the affected finger exposed to any chemicals or other irritants?
Customer: replied 6 years ago.

I don't get any pus but the tip of my finger is harder skin than the rest and the sensation isnt as strong to touch. I am a stay at home mum to two children under 5. Thankyou
Expert:  Dr. Nair replied 6 years ago.
Hi again,

I'm so sorry, was down with the flu since the 29th and haven't managed to get back to you. Do you still want to work on your question?
Customer: replied 6 years ago.


Yes please, I have been away for a week anyway on holiday to Eygpt and my finger was a lot better. As soon as i got home it has gone back to being bad

Expert:  Dr. Nair replied 6 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Ok great. Whenever a patient presents with symptoms similar to yours there are a few possibilities to consider - 1. Acrodermatitis Continua of Halopeau 2. Parakeratosis Pustulosa and 3. Fingertip eczema.

Acrodermatitis Continua of Halopeau (ACH) is a form of psoriasis of the fingers. It is characterized by pus filled blisters involving the nail folds with gradual spread down the finger towards the palm. This is ruled out since you clarified that you have not noticed any pus filled lesions.

Fingertip Eczema is also ruled out since this usually involves the tips of multiple fingers, is sort of shiny & glazed in appearance and does not usually have any distal nail changes in my experience.

That brings us to Parakeratosis Pustulosa (PKP). This is a condition similar to ACH but has no pus filled lesions. Usually one finger is affected and the nail of the affected finger often shows distal onycholysis as evident in the photographs you sent me (this is the white detached part of the free edge of the nail). The condition also fluctuates in intensity spontaneously as evidenced by your trip to Egypt. The cause of PKP is not known presently and it needs to be treated with prescription drugs. What I first try in my patients is a combination of a potent steroid cream like clobetasol or halobetasol at night and tacrolimus (0.1%) ointment twice a day in the morning and early evening. I would suggest discussing my suggestions with your GP/Family Physician.

Hope this helps!