What Causes Skin Cracks On Fingers?

Brief Answer:
Allergic contact dermatitis/ Eczema/ Psoriasis

Detailed Answer:
Hello XXXX

Welcome to healthcare magic.

I understand from your history and description that you are having scaling and fissuring involving your fingers of a long standing duration which is a recurring problem.

The possible diagnosis is would consider in a case like this would be -
1. Allergic contact dermatitis- This occurs as an allergic reaction to some outside allergens. What is your occupation? Do you have any hobbies? Common allergens include latex gloves, rubber ( which could be in gloves, bike rubber handles, steering wheel grips,etc) , plants ( like marigold, crysanthemum, parthenium,etc) , chemicals (like paints, turpentine) and detergents ( washing powder, dish washing soap,etc). Please think about whether you have contact with anything which could cause allergy. External allergens could be the cause for your recurrent lesions.

2. Eczema / Hand dermatitis - This is a common condition seen in elderly individuals who also have dry skin. This cannot be completely cured but controlled with regular and frequent use of moisturizers.

3. Psoriasis - This usually occurs a s well defined , round patches of thick skin and from your description, this seems unlikely. However, since you are having a recurring problem, I would keep this in mind.

I would suggest to you the following -

1. You can apply a steroid - salicylic acid containing cream like Dipsalic cream which you are currently using on the cracks for 2 weeks. However, this should not be used for a very long time and hence stopped in 2 weeks.

2. Use a good moisturizer containing urea, lactic acid, squalene, etc ( e.g- Moisturex cream ) repeatedly every 3-4 hours. This is the mainstay of treatment. This will prevent drying of skin and further cracking and recurrences. Apply it on damp skin preferably.

3. Use a soap free cleanser like cetaphil cleanser to wash your hands. Do not wash hands frequently. Excessive washing will remove the oil from the skin and make it more prone for cracking.

4. Think of any possible allergens which I have listed above and try to eliminate it.

5. Avoid touching detergents directly. Use a latex free glove if you are washing vessels/ clothes. Also avoid cutting vegetables like onion and garlic which could worsen eczema.

I hope this helps you.

If you have any more queries, I will be glad to answer.

Take care and wish you good health.

Regards,
Dr. Johny Chacko

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Brief Answer:
Eczema/ Allergic contact dermatitis

Detailed Answer:
Hello Sir,

Thank you for the additional inputs.

From your occupational history, I do not think that you used to touch any chemicals.

As far as a 2 wheeler is concerned, using a rubber grip on the handles could cause allergies. Please check if you have one.

Yes. I understood from your history that the lesions recur on stopping the medicines. This problems is of that nature that it recurs on stopping all medicines. That is the reason that you should continue moisturizers even after stopping dipsalic. Use moisturizers on a long term basis and make it a part of your daily routine. Stopping it could make your skin dry and more prone for such allergies.

You could also use coconut oil if you do not mind the stickiness.

Hope this has helps you.

Wishing you good health,
Dr. Johny Chacko

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