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Suggest Remedies For Painful Blisters On Hand Caused After Lunging A Horse

Posted on Sat, 14 May 2016

Question: I have a painful callous with a blister underneath of it on the upper side of the palm of my hand that won't heal for the past 8 weeks. Got blisters after lunging a horse without gloves, then blister turned into this ongoing callous/blister. I Went on antibiotics Cephalexin 500 mg 3 times a day one week ago. No better. It's forming a tender callous like before with a painful blister underneath. I'm in very good health otherwise but this painful blister on my hand is sucking the life out of me as its still red & sore & tender to the touch.

does it need to be lanced or removed? I've had several cystic masses on my back & inner thigh which have had to be surgically removed. But this sore blister/callous on my upper inner palm of my hand does not seem to be healing , just getting a thicker callous around a more painful blister.

Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)

Brief Answer:
Upload an image /images please

Detailed Answer:
Hello and welcome

I appreciate your concern

If appropriate, Kindly provide some good quality images of the blister/sore that you mentioned to comment accordingly.

let me know if you have any query

Wishing you best of health

Thanks

Dr M.S Khalil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (21 hours later)

Dear Dr. XXXXXXX

I just uploaded pictures of the blister on my hand. I hope the resolution is clear enough for you or I will try again.

The blister certainly seems to be very determined to stay. The callous is starting for form over it so it will be well protected.

You wouldn't think something so small could be so bothersome. But oh it hurts! And if I pumice the callous down the blister bleeds a ridiculous amount.

I'd be quite happy to have it surgically removed! As I say, it seems to be not going anytime soon and it's quite painful.

Answered by Dr. Dr. Muhammad Sareer Khalil (6 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

Blisters after horse lunging without using gloves are common one should always use gloves for that as the friction tear off the skin of palms and result in injury and blister formation , it may be infected secondarily with bacteria to further complicate the matters; the callous formation is normal body response to try to heal the area which may be some time exaggerated. Cephalexin as the antibiotics choice is fine and local antibiotic such as fucidin acid plus betamethasone ointment will also be helpful. Culture can also be taken form the lesion and if it still persists biopsy can also be opted for. In that case if a biopsy is planned the cyst can be removed / excised surgically.

let me know if you have any query

Wishing you best of health

Thanks

Dr M.S Khalil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (16 hours later)

Thank you kindly. It was silly of me not to use gloves while lunging my horse. I now appreciate what complications can result from tears & trauma to the skin.
The antibiotic hasn't worked & ive been on it 7 days. I'm hoping that I can proceed with a biopsy & excision as I think it's warranted at this point. The blister is not going away & bleeds profusely if I soak the callous over it.
I almost wonder if it's still infected.

Answered by Dr. Dr. Muhammad Sareer Khalil (4 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

Though a biopsy would clear things up, I would also recommend getting blood counts including platelets done. Coagulation profile including PT APTT and INR should be done. Blood sugar as part of basic metabolic panel can also be ordered to rule out other causes.

please consult your doctor before taking any further course of action

Wishing you best of health

Thanks

Dr M.S Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (42 minutes later)

No worries I've had a recent blood count. Blood sugar excellent, BP excellent. I had eczema as a child & my skin is my weakness. I had a horrific staph infection from a botched laser treatment on "chicken skin" on my upper arms a few years ago. I still have scars. Doctors were amazed I wasnt hospitalized.
My father passed away at 92 - massive stroke after fertilizing his garden during 98 degree heat. The 10 minutes I left him alone! Well my Mother is 92 & healthy, an aunt just passed at 104. Wish that doctors would just treat the infection.

Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again

Thanks for providing the details.

If the cephalexin is not leading towards resolution of the wound/lesion then empirically amoxicillin clavulanate can be an option. Unless culture sensitivity testing is done it would be difficult to predict about a specific antibiotic working for sure.
As the results of the biopsy and culture sensitivity are available, one can tailor the treatment accordingly.

Wishing you best of health

Thanks

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar