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Dermatology/Raised bumps on hands and fingers

Expert: Michael S. Fisher, <B>Ph.D., M.D.</B> - 10/2/2008

Question

Greetings Michael
I am also on all experts under the massage therapy category.
The question I have for you is regarding my wife. 5 days ago after giving a massage to a client, my wife experienced an intense itching in the palm of her left hand. Hours later 6 raised bumps about 2mm wide appeared. We purchased an over the counter cortisone cream, the itching subsides. Each day a new bump appears around the initial area and now appearing between her fingers.
The observed pattern is a raised bump that creates a point, then in a couple days subsides to a lower bump with a darker pigment present.

Any information would be greatly appreciated.

Regards

Answer
This type of skin lesion can be called Papular Urticaria. This can be caused by a bite ie spider or flea or mosquito. Treatment is with topical steroids. Other causes can be an allergic reaction to something that came in contact with the skin. Treatment again is with topical steroid - prescription topical steroids is the most effective ( I like Clobex Lotion ). Other causes of this type of rash on the hands and between the fingers can be scabies which is treated by Elimite or oral ivermectin. If I saw her in the clinic I would scrape the lesion and look under the microscope. If the topical cortisone does not work then you would need a visit to the local dermatologist. A biopsy of one of the skin lesions is definite for the diagnosis.

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