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??

@ViperAtTheGatesOfDawn

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

Ah yes we have seen him a few times as well. We see dr swan now I think. It's changed over the year's.

But when it's at its absolute worst you want to see the top dogs. Especially if you're paying for it.

Could it be a fungal infection?

If it’s grown in size it could be worth asking for it to be tested.

OP, I had this last year. 120mg Fexofenadine didn’t touch it. 180mg had a minor effect. I now take 2x 180mg AM, 2x180mg PM (720mg/day). That has shifted it.
120mg useless, IMO. 180 had some effect, finally.

Your poor DH.

With your more recent update, I'm starting to think MCAS. Mast Cell Activation Syndrome. Google it. Lots. I have it. But no skin involvement for me. It's an immunological condition & he is already ticking many of the symptoms boxes.

It can be very difficult for UK immunology to recognise & diagnose this condition & specialists have long waiting lists. But it's possible to improve symptoms once you follow a low histamine diet + stabilise the mast cells with medication.

Hope you find the root cause. Best of luck!

*Some MCAS people take Fexofenadine, but it's prescribed 3-4 times a day, along with loads of other stuff.

@cloudsofceonothus this is really interesting particularly as his immunology nurse believes that some of his anaphylactic episodes are idiopathic.

@biggerbetterhealthier we are in Manchester any ideas? I don't care what it costs at this point.

Have they tried him on montelukast. I have dermatitis and urticaria of unknown origin.

I really feel for him. It must be horrendous. I do think he needs to rethink his career though if he was fine when not working. Has it ever cleared up before while he was on holidays from work? Or was it just this time with him being off for a long time?

Some Immunologists are great & do understand MCAS. Others will only diagnose idiopathic urticaria or angioedema & treat just that. But mast cells are all over the body & can trigger each other so it needs a comprehensive approach.

Dr Grattan in London is a good MCAS dermatologist I believe.

If you email this charity with specific symptoms & your area, they can direct you to the right doctors to see. www.mastcellaction.org/ The site also has a symptom list but it's not so comprehensive.

Maybe this is better: ukmasto.org/about-mcd/

Montelulkast can also be prescribed for MCAS

@corianderBee when you say optimizing his steroid cream what do you mean?

@goldierocks thankyou so much for taking the time to write such a comprehensive response. I'm going to look into seeing a private derm and will ask about the allergy testing.

@biggerbetterhealthier you've hit the nail on the head again

He knows, I know, his bosses know that he needs to not be a chef anymore, but he feels too old, too stuck in his ways to retrain and wouldn't have a clue where to start (he's also scared stiff of the prospect) but we have a large family, and a disabled DS that needs 24hr care/supervision so he very much feels the weight of "needing to provide" although I have told him I will gladly eat beans in toast from now until eternity if it meant he was no longer in pain

@notaroadrunnet no olidats have never been long enough to clear it, there have been improvements but only extended leave cleared it completely

@hankunamatata nope never heard of it, I asked about retinoid therapy once and the dermatologist laughed and said it's "far too expensive, you've got no chance".

Olidats = holidays obviously

Montelukast is tablet gp can prescribe. Can be used for all year round allegies

I take fexofenidine, montelukast and then omeprazole to protect stomach

www.ncbi.nlm.nih.gov/pmc/articles/PMC4589848/

If you live near Manchester please try Pall Mall medical. The dermatologist I saw was brilliant, I had been put on steroids for eczema but it’s too much of a shock to the system to do them for 7days then stop suddenly. He prescribed a course over a month starting off with a high dose and less and less. I can’t recommend them enough!!

Different dermatologist?
I’m on methotrexate now. Plus fexofenadine. Life changing.
Daft question! Is work uniform laundered differently from other clothes?

Update DP boss is now saying he's going to be dissmissed as he is unable to work this weekend, they have made no attempt to offer flexible working or adjustments at work etc . . I know they don't have a leg to stand on but we really don't need the hassle of a tribunal

Thankyou @chickenlips789 a personal recommendation goes a very long way and we are in Manchester I will be contacting them this morning

So sorry to read that Rabbit, whilst it might be the best thing for dh's health long term, I can imagine that it will increase stress in the short term. Fingers crossed he can find new work soon 💐

Try antihistamine tablets for a couple of weeks - my BIL did and his cracked hands are completely healed for the first time ever