Hello, Thanks for your query on HCM As per your clinical history is concerned please follow like this - 1)Do a clinical examinations by your [dermatologist]for any abnormal signs and do a Skin biopsy to confirm it. 2)Do take all prescribed medications as per clinical findings only and discuss physiotherapy with your physio. Do follow few lifestyle modifications like this - 1)Try to wear gloves or mittens outdoors when the weather is cool and indoors when you reach into the freezer. To maintain your body s core temperature when it s cool, dress in layers and wear a hat or scarf, thermal socks, and well-fitting boots or shoes that don t cut off your circulation. 2)Try to avoid smoking 3)Do exercise regularly 4)Change eating habits a)If you have difficulty swallowing, choose soft, moist foods and chew them well. b)Eat small, frequent meals c)Avoid spicy or fatty foods, chocolate, caffeine, and alcohol d)Don t exercise immediately before or after eating e)Try to elevate the head of your sleeping bed f)Sit upright for three hours after a meal 5)Try to avoid harsh soaps and detergents. Choose cleansing creams or gentle skin cleansers and bath or shower gels with added moisturizers. Use rubber gloves when doing the dishes or cleaning. 6)Reduce bathing frequency. Bathe just once a day or every other day, and take brief baths and showers, using warm rather than hot water. Apply a rich oil-based moisturizer immediately after washing your hands or bathing, while your skin is still damp. 7)Try to apply sunscreen before you go outside. 8)Try to Increase moisture levels in your home by using a humidifier. 9)Do regular checkups and use any special rinses or toothpastes your dentist recommends. Hope that helps