These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.
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I do not know what happened as I thought I had posted an answer. We have had snow, and freezing temperatures, and I have had some problems with the site in general. At any rate, I apologize for the inconvenience and will try again.
I would offer the following suggestions:
1) A skin biopsy to be sure what is going on. A fungal culture if that has not been done as of yet. This might be psoriasis of the hands and feet ( Psoriasis of Barber) and might respond to anti-psoriasis treatment. It always helps to nail down the diagnosis and work from there. If this turns out to be consistent with an allergic contact dermatitis, patch testing might determine what is bothering you. In patch tests, strips of chemicals are placed on the skin and taken off in 48 hours, examined and checked another 48 hours after that. It is axiomatic in dermatology to check for a fungus ( Tinea Pedis). A small amount of fungus can lead to a marked reaction. What I am saying is that the hole area might not be a fungus, but the fungus can set off a reaction ( called an id reaction) that can then affect the feet and hands to an extent not proportionate to the amount of fungus.
2) Ultraviolet UVB light therapy. I have found this to be wonderfully effective in treating this sort of thing. Usually two treatments a week for 8 weeks ( three would be even better) substantially improves the situation. There are home units that can be prescribed. This is a very safe treatment. Some would also recommend PUVA ( psoralen + Ultravioet A). This is more complicated as it requires taking a peel and having the light treatment two hours later. Special sunglasses must be worn for two days afterwards.
3) Soriatane. This is a Retinoid, i.e. a Vitamin A derivative. I have found this to be quite effective for what you have. There are a lot of side effects to it, however. It can be used in conjunction with the other medications. It does not suppress the immune system. Usually, a four month course should be effective. The dose I use is 25 mg. a day. However, it is best to start at 10 mg. a day. Triglycerides should be checked. I would be sure the physician prescribing this, is familiar with using it.
4) Your physician should try a compound consisting of Lactic Acid, the Salicylic acid and crude coal tar. This is messy but often works. Alternatively, an anthralin topical cream called Drithrocream might be used. This can be applied at night. It also is a bit messy.
Those are a few ( hopefully helpful) suggestions. I do apologize. I swear I do not know why my previous post to you did not register. Feel free to get back to me.
Oh yes, the best place to get treatment would be a general medical dermatologist.
Please let me know whether you have any further questions.