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Dermatology/How to effectively cure chronic finger dermatitis?

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Question
My two thumbs skin under the nail and around the finger peels off and sometimes form a white empty blister first. There are no swelling, pain and itch. After soaking the thumb into the water, the skin changes to white. The skin under the nail has changed to a little thickening due to the frequent peeling off. In the past I soaked my hand into the dishwashing liquid without a glove. Then I noticed the skin was very dry and flaky as well as after shower. I have seen different dermatologists but got two different diagnoses, chronic paronychia and chronic eczema. The doctor diagnosing chronic paronychia prescribed antifungal medication and topical corticosteroids, Topicort while the doctor diagnosing chronic eczema only prescribed topical corticosteroids, Diflorasone. I have noticed applying either the Topcorat or Diflorasone caused the skin peeling off. Probably both of the diseases are considered the dermatitis and the treatment is the same, clear the finger inflammation. Is it correct? If so, can you tell what medication is most effective for the chronic paronychia and chronic eczema on the finger? Thank you for your answer.

Answer
How can chronic paronychia be treated?

To work well, treatment has to alter the things that started it; this is not always easy. It may take as long as six months for the cuticle to reform, and until it does, the problem may recur. Your own actions are of great importance here (see below under ‘What can I do?). In addition:

apply an anti-yeast cream or lotion to the inflamed areas several times a day. Sometimes a steroid in the preparation speeds up a cure.
if a swab shows that particular bacteria are playing a big part, your doctor will select a cream that works against them.
in more severe cases, or if the local applications have not helped after a few weeks, it may be worth taking a course of anti-yeast tablets, or antibiotic tablets if the swabs suggest this.
usually there is no need for surgery.
underlying conditions such as diabetes, or thrush,  must also be treated.
What can I do?

You should keep your hands as warm and dry as possible; you will not get better until you do this.  
Avoid biting your nails, manicuring your nail folds, and pushing back the cuticles.
Do not use nail varnish until the condition has been treated.
Occasionally a change of job is worth thinking about.  

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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