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christos kasparis
christos kasparis, Board Certified Dermatologist
Category: Dermatology
Satisfied Customers: 134
Experience:  MBChB, MRCP, FRCP (Lon)
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I have badly cracked fingertips. This was for about 2 years

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Hi. I have badly cracked fingertips. This was for about 2 years only on my thumb, then moved to other fingers and it is now on both hands. Washing the hands, touching food to prepare dinner, etc makes it really bad. I have tiny dry patches on my elbows (few months now), very dry skin on feet and I feel it starts to appear on the underarms. Could it be psoriasis?
JA: How long have you been dealing with the skin issue? Have you noticed any major changes in your overall skin or nails recently?
Customer: Few years now. Starting from just one finger and spreading. The skin is very dry
JA: Anything else in your medical history you think the Doctor should know?
Customer: About 2 years ago Vit D deficiency, weight gain. My thumb nails were a bit deformed and with dark tiny lines when I was with vitamin D deficiency but they seem to fine now. Just the skin is very, very cracked at the tips of the fingers etc
Customer: replied 1 year ago.
I can upload images

Hi I'm Dr Kasparis Dermatology Consultant, please call me Christos. I am sorry to hear about your skin problem. Images would be extremely useful including your nails if you could.

Can I also ask if you have a family history of skin problems? Does the skin itch in these areas? Have you had eczema as a child or do you suffer from asthma or hayfever at all? Have you used any creams so far or seen the GP?

Customer: replied 1 year ago.
File attached (4Q7ZMTS)

Thank you , have you got any of your elbows, feet , armpits or nails? these would really help

Customer: replied 1 year ago.
I used creeams and in the past petroleum jelly at night was very helpful. However, this doesn't help at all anymore. Also I am using Cetraben, E-45, Oilatum light liquid paraffin but there is some improvement if I don't toutch anything. My skin is itchy sometimes. Sometimes it gets red and itchy on the top of the hand but disappears fairly quickly after I put cream on that
Customer: replied 1 year ago.
Nails

Great thanks, ***** ***** photos would be very useful

Customer: replied 1 year ago.
File attached (L611TTQ)
Customer: replied 1 year ago.
Elbow
Customer: replied 1 year ago.
Another Elbi
Customer: replied 1 year ago.
The better hand
Customer: replied 1 year ago.
My thumb. The nail was very wavy when I had the deficiency but it is ok now
Customer: replied 1 year ago.
My elbows are not that bad yet. Sometimes they are itchy too.

That's great thank you. From what I can see on your fingers, you have quite severe fingertip dermatitis. This is a form of eczema that usually develops over time and often is due to irritation through regular washing with soap, using various detergents in washing liquid etc(irritant contact dermatitis). I cannot see any specific signs of psoriasis in the photos you have shown me and in your nails. The treatment I would recommend would be:

1. Avoid excessive washing and always use protective gloves when in contact with washing liquid. Ideally, you shoudl be using Dermol 500 lotion as a soap substitute (can be obtained from your GP)

2. You need regular moisturizing with an ointment as opposed to a cream- Hydromol or Epaderm ointment can be very useful

3. Diprosalic ointment to apply to affected areas every night for 2 weeks and then as required- this can be obtained from your GP, it will reduce the dermatitis and allow the skin to heal nicely.

With careful hand care the problem will improve but may never go away completely so you may need to use this treatment from time to time.PLease visit this site for more advice from the association of Dermatology. I hope this helps!

https://www.bad.org.uk/for-the-public/patient-information-leaflets/how-to-care-for-your-hands/?showmore=1&returnlink=http%3A%2F%2Fwww.bad.org.uk%2Ffor-the-public%2Fpatient-information-leaflets%3Fpage%3D10#.Xt0iwGhKhyw

If you have any more questions please just ask

Customer: replied 1 year ago.
This is an acceptable diagnosis but then I don't wash my elbows that frequently and it started appearing there too? Is it the same thing?
Customer: replied 1 year ago.
Thank you very much

You are right irritant dermatitis mainly affects the hands and fingertips but sometimes other areas of high friction can be affected too. From the photos you have shown me I cannot see definitive signs of psoriasis , unless I am not seeing the elbows at their worst at the moment. If this is as bad as it gets on the elbows then I don't think you have psoriasis it is more a dermatitis. If you have any other parts of the body( feet,armpits ) to share then I would be happy to review these. The treatment however would be very similar even if you had mild psoriasis on the elbows.

Customer: replied 1 year ago.
File attached (Q4121S3)
Customer: replied 1 year ago.
From the armpit towards the back

Thank you,again no signs of psoriasis here but in keeping with mild dermatitis and dryness

Customer: replied 1 year ago.
Ok, many thanks. The water here is very hard water. Is this something that also contributes to such problems? Should I consider water softener?

Absolutely. Harsh water certainly causes a breakdown in the skin barrier and contributes towards the irritation. If you use a water softener it would help however avoid it until the cracked areas on your fingertips have healed first with the treatment above otherwise it may sting !

christos kasparis and other Dermatology Specialists are ready to help you
Customer: replied 1 year ago.
Thank you very much for your time! I feel a bit relieved reading this isn't psoriasis although it may not be better but still. I'll follow your advice.Many thanks and have a good day.

Thank you and a pleasure , I hope you feel better soon.