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Skin Infection On Finger, Dead Skin Around Nails, Recurring Blisters When Immunity Weakens. Guidance For Treatment?

Posted on Tue, 28 May 2013

Question: Hi,

I have a skin infection for the index finger of my right hand since 1997. I got this probably due to the water at that time, as I had other infections too during that time like scabies. But all of them are healed immediately by medical care, except for this problem. Here are the symptoms.

1. my index finger nail has become dark, with dead skin piling up underneath the nail ( as i understood).
2. Every couple of months i get blister like formations around the nail, which when poked will relase a water like sticky liquid. That part of the finger feels itchy and I feel comfortable if I dip the finger in warm water.
3. I guess that these blister like formations appear when my immunity weakens a bit, but have no clue why they appear and heal on their own.

I got it diagnosed recently too but not of the external/internal medications helped in curing the problem completely. So I wanted to take the help here and get some guidance if feasible.

thanks
XXXXXX

Answered by Dr. R.G. Joshi (6 hours later)

Hi Sir,
Welcome to XXXXXXX
Thanks for writing here.

I have gone through your reports, history and photographs. There are 3 problems in your nail:

1.Formation of dead skin under nail and lifting up nail, this is most probably suggestive of a fungal infection.
2.Formation of blisters around nail which shows nail fold involvement which again may be due to fungal infection or allergic component.
3.Darkening of your nail, it can occur in fungal infections, but it is common in other diseases of nails.

So based on these clues I can think it may be a fungal infection, but before going in details I request you to send me following details

1.Oral medicines you have taken if you remember.
2.History of diabetes in your family.
3.your occupation.

Please follow up with these details and we will continue our discussion.
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. R.G. Joshi (2 hours later)

Hi Dr. XXXXXXX

1. Thanks for reply. I am mostly avert to medicines, unless its absolutely necessary.
For all my skin problems, i havent taken any oral medications. Only ointments/creams. For this problem I have included the prescription that i used in the uploaded report (pdf file contains it if u scroll down).

2. My grandfather and father had diabetes. while my mother tree has not got any diabetes, my mom is showing signs of it now (her age 65 yrs).

3. I am a software professional.

thanks
XXXXXX

Answered by Dr. R.G. Joshi (17 hours later)

Hi XXXXXXX

Thanks for follow up and giving details.

Your problem seems to be a fungal infection .It can be treated by oral medicines or by surgical methods. Oral medications include antifungal drugs like fluconazole, itraconazole etc. They have to be taken under the guidance of a dermatologist and they are slow to react. Since you are having nail problem since 1997, it will be better if you go for surgical option. Dermatologist routinely performs nail surgeries now a day. It is usually done under local anesthesia. Total nail can be removed and also it can be send for pathological examination which will help for further treatment. You can either consult a dermatologist who is specialized in doing dermatosurgery.

Stop using lobate cream; it is a steroid. It is not advisable to apply it without any confirmed diagnosis.

Hope I have answered your query. If you have any further questions, I will be happy to help.

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Shanthi.E