Can you help me identify a skin condition??

[Rabbitheadlights]

Posting for traffic

We are 7 years down the line with GP, dermatologists etc and the only explanation ever given is eczema, nothing works, it's extremely painful often cracks and bleeds present on hands, inner arms and under arms. DP is a chef while on furlough it disappeared completely ?? Any ideas??

It doesn't look like urticaria to me (I have spontaneous and cold induced urticaria) and the blistering definitely doesn't sound right. I'd guess at some kind of dermatitis, not necessarily caused by stress, but probably worsened by it. If possible, it's probably best to see a private dermatologist. No one in the NHS cared at all about my urticaria, one GP even intimated I was making it up...

@lawandgin this has been our experience they seem to think it's just a minor ailment and DP Should essentially just suck it up! But the pain is real I've seen DP sob lately all 6ft 2 of him literally shaking and sobbing because the pain and the itch is so intense

Has he had checks for an autoimmune disorder, is he eating different food in work?

@emeraldshamrock no tests no suggestion of autoimmune? No difference in diet

@Rabbitheadlights oh I'm sorry, that's horrible. Urticaria was ruling my life and like your OH, I was expected to just get on with it. I saw a private specialist who gave me treatment options, but most importantly, believed me and wanted to help me. Best couple of hundred quid I could have spent.

@lawandgin i wouldn't even know where to start, i don't know if it's allowed so apologies if not but can you recommend someone or a particular company??

Looks like my eczema. Could be caused by sweating in the heat of a kitchen. If I sweat my eczema ramps up a lot. If he hasn't had eczema before then it could be allergic eczema / contact dermatitis. Swap out his deodorant, laundry detergent for sensitive and fragrance free. Plus stop using any softener or fragrances.

Looks like he needs oral steroids for a time, but after that other than topical steroids it's pretty hard to get treatment.

Light therapy, methotrexate and in severe cases Dupixent are sometimes prescribed for eczema but you'd need to be referred to a specialist.

And yes, eczema can be hell and is often misunderstood. Took me 25 years of suffering with severe itching, pain, infections... I've sobbed too so he's not alone in that!

Def ask for a referral and push for further options if it's causing his distress, affecting his sleep and his mental well-being. I find dermatologists far more keen to help than GPS who don't get much training on skin issues.

Just seen you've already seen a fern and they've not done anything. This happened to me a few times. Make sure you're optimising his topical steroids. But, also push for another referral. It took me three to get the right treatment as they have hoops to jump through and some can be crap. Eczema treatments can be very expensive so they're often hesitant to prescribe them.

Be very very obvious that it's affecting his quality of life and that it's affecting his job. You have to make them see the severe affects. Good luck.

@Rabbitheadlights the specialist I saw was about 80 years old at the time and I've just googled him and sadly, he's longer with us! I found him after lots of extensive googling, but ultimately I think I was quite lucky. You could try looking at your local private hospital's website and their derm consultants. Google each one individually to try and find reviews, or if you let us know what area you're in, maybe someone here can recommend someone?

Your latest description sounds more like pompholyx eczema.

My experience of pompholyx isn't anything like the OP describes ,apart from anything else it was crazy itchy for me with small fluid filled blister.

Hi @Rabbitheadlights

This part of one of your recent posts jumped out at me: "...hundreds of tiny blisters, insanely itchy......then morphs into the massive red patch and begins to crack and bleed and blister"

Thats exactly how my urticaria manifests itself.

Like your poor DH, my original G.P. and dermatologist wanted to treat the symptoms rather than what was causing it in the first place. I should probably add that I was a child when it started and was referred to Great Ormond Street. None of the treatments I was given worked and I was discharged while the urticaria was getting worse.

It's a very long story which I won't bore you with, but to cut it short I had long and exceptionally thorough sets of allergy testing, way way way more detailed than the tests offered by the NHS, which I'd also had.

The private tests obviously picked up the same things as the NHS ones, but I also came away with details of ingredients which are used to make seemingly everyday products that I need to avoid.

One of mine is an ingredient that is commonly used in liquid hand soap. It was a lightbulb moment. My urticaria would be much better after the end of term school holidays; my school used a certain soap that was causing a reaction. I'd improve when I wasn't using that soap (ingredient) at home.

As your DH got better when he was on furlough, I think he's experiencing something similar to me; he's being exposed to 'substances' at work which are causing the reaction that you don't have at home. This could be things your DH is touching, eating or even breathing in (aerosols).

Unfortunately treating the resulting symptoms won't be a permanent solution. I would definitely recommend private detailed allergy testing. It's not easy living with the results (literally need to check every ingredient on every label). I found that after a few years of complete avoidance, I can tolerate some substances which used to cause an instant unpleasant reaction.

I hope your DH is able to recover, it's a miserable condition to deal with, but it is possible to get on top of it

The localised reaction on hands, arms and underarms makes me wonder if it's the gloves. Does he wear the gloves for any reason when not working?

You said he wears latex gloves over cotton gloves, and have also mentioned a raw tomato allergy. Latex allergy can go hand in hand with tomato allergies.

Check the gloves. If they are latex then try a different material such as nitrile. If he's already using non-latex gloves then explore different non-latex materials.

** so sorry , I missed the bit about the OP saying it's really itchy! Pompholyx a possibility then. Does he use shower gel? I got rid of mine on my hands by nit using Carex hand wash and switching to bars of soap.

@goldierocks that's really interesting and so different to how I experience urticaria! Mine never blisters and only bleeds from my incessant scratching! Do you know what type of urticaria you have? X

@goldierocks sorry I'm still half asleep, I guess yours is allergy based from the rest of your post.

I agree, your description sounds like pompholyx.
Usually steroids help.
If at all possible he needs to track down a cause abd you know that it is work related. Management should be two pronged ie treat symptoms to try and get on top of it and to see if a cause can be found. I would ask to see a dermatologist again with a view to allergy testing.
He clearly can't go on as he is doing but if it is a case of the soap at work or latex gloves etc alternatives can be found.
I get it occasionally from washing soil off potatoes so I now buy them from the supermarket washed in a plastic bag. I'm lucky to have tracked down an easily avoidable cause.

Hi @lawandgin - mine is acute urticaria caused by various allergies. I couldn't eat chocolate or eggs or drink pure orange juice at all for years (I can tolerate them all now in small, infrequent amounts). Certain brands of soap, shampoo, body wash and toothpaste also cause reactions along with household cleaning products. I curse manufacturers when they change ingredients on my 'safe' list of products! I've also got some unrelated long-term medical conditions and I needed to have the drugs swapped over when the original ones started to cause the urticaria to flare.

My long and boring story was basically that I was part of a medical trial, hence the huge amount of tests. I was treated with a very low-dose injection of epinephrine every week for three months (I had to stay in hospital for a day each time for monitoring), but it massively improved my condition.

I really feel for the OP's DH and hope he's able to get it sorted. I'd like to add that if his condition is being caused by substances/ingredients that he’s exposed to at work, his employer should be supportive of making reasonable adjustments to reduce/eliminate contact as much as possible.

Not sure exactly what that is but my friend saw a private doctor for a rash that wouldnt go away and he recommended simple Aqueous cream with menthol to stop the itch- scratch cycle so it can clear. If your DH is that bad though has he thought about getting seen by the doctor and asking to be signed off work as it seems work is one of the causes of it. It would give his skin a chance to heal and he could be shirtless at home. He really needs to tell them how bad its making him feel. Good luck.

@Rabbitheadlights

Ok ...

Thanks @mrspelligrinopetrichor I will look into eucerin

@jewelgarden that really looks like it under the arms, but under the arm is a very recent thing this tends to start on his hands like hundreds of tiny blisters, insanely itchy then the inner elbow and down the inner arm. It then morphs into the massive red patch and begins to crack and bleed and blister.

DP wears a clean fresh uniform every shift and changes his cotton gloves around 4-5 times during. I will look into maybe getting him allowed time to wash and change during shift.

@castlepeak can I ask what the shot is ?

He has had allergen testing which picked up contact dermatitis reactions to raw chicken, chili and onion.

DP also suffers anaphylactic reactions to ingested raw tomato and lettuce and carries an EpiPen this complicates things further.

Thanks @knittinglikemad

@pixxie7 you would think so but tbh the dermatologist is useless he prescribed hydromol and basically told DP to learn to live with it and the discharged back to GP.

@biggerbetterhealthier thanks for your responses they are really helpful DP Does have intense burning itch all over pretty much constantly I don't know why I didn't mention it, the pain is the most difficult thing to manage at the moment but is probably not helpe by constant scratching

Your update is interesting.

My son carries an epipen and is allergic to a mad list of foods similar to your partner. And also suffers without breaks or urticaria.

I think given what you have said it's probably a lot more simple that you think.

If you break it down at least.

1- he has food allergies. Severe enough that he carries an epipen.
2- he works with food.
3- he has an allergic response type of rash, and often feels it all over.
4- it stopped when he stopped working with food.
5- it returned when he started working with food.

No wonder he hates his job.

It's quite literally a health hazard for him

And also suffers without breaks or urticaria.

I'm not sure what that was supposed to say. But it wasn't supposed to say that.
I hate it when my phone second guesses me.

[quote Rabbitheadlights]@lawandgin i wouldn't even know where to start, i don't know if it's allowed so apologies if not but can you recommend someone or a particular company??[/quote]
There's a man called Dr Adam Fox who works for the NHS as paediatric but is also adult trained and works privately.
He's one for be best in his field, he is a good man to speak to.
If you live near London anyway.

There's other places I could recommend depending on where you live.

Adam Fox

Cut out all sugar and alcohol; eat as fresh a diet as possible plus loads of water. Apply emollient.

BiggerBetter I've seen Adam's partner in private practice and adult allergy consultant, Prof Stephen Till, and he's amazing too.