Brief Answer: Full measures of prevention & moisturization Detailed Answer: Hello young fellow, I very well remember your part of query for torn out skin above nails for which I guided you previously. I have gone through latest of the pictures sent by you and can make out that the condition is better than before but still persisting. As I guided you before that your condition is basically allergic contact dermatitis. In most of the cases of your type of condition it is the proper protection and care which is sole most factor to prevent any cuts or peeling of skin or redness. In many a cases despite all the factors of prevention we are not able to prevent the further aggravation of the problem. As I told you before that the first and foremost of the thing is to do warm compression two times daily. By doing so the concentration of allergens such as soaps and detergents and even dust particles causing the allergy are washed away. The second most important part of prevention is to apply a moisturizing cream continuously and regularly. In some of my patients of your kind of problem I guide to apply the moisturizing cream for atleast every hourly or up to 10-15 times. There are certain more moisturizing creams which can be acting as both barrier function as well moisturizers (such as DERMASHIELD CREAM) which can be applied for multiple times a day. The next part of resort is to apply a topical steroid cream as guised before for mometasone cream. It can prevent the existing lesions as well as formation of new lesions. I can see that the condition is better but I can also see that you have probably applied the cream on higher side. I can make out whitish appearance of the skin near the affected areas of thumbs. This is due to higher application of the cream which causes whitish appearance. A rule of thumb is that a pea size amount on finger tip is sufficient for palm size area. SO in your case you should take only very little of the cream and that too is to be applied over the affected area only and not beyond that for two times initially and then to once and alternate day before completely stopping it. For moisturizing cream you can apply as much as you want. Despite all the above measures if the lesions are not subsiding then the last measure is to start oral steroids as shot course but only under strict dermatological supervision. In my view your condition is quite simple and not that aggravated that it requires any oral steroids at this time. You can follow the above regime judiciously for next few weeks. Rests of the suggestions are as previously. Still if you find problems then can go for a special test known as “PATCH TESTING”. It gives the idea of most probable agents causing the problem. For the same you can visit a good dermatologist who can perform the test and can guide you accordingly. Overall I quite often see your kind of problem in my day to day practice and by simple measures of protection we are able to handle the situation better. I hope these information's will help you. If you have further queries I will be happy to help. "Wish you good health" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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Brief Answer: You will be totally alright Detailed Answer: Hi young fellow, I am happy to know that you would be visiting Jaipur next month. Do meet me if possible so that the things can be seen guided physically. Regarding your full body check up- you can very well go for the same as a part of health consciousness, but form the part of your skin problem everything would be totally alright. With all my best health wishes for you. Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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