Can anyone help with my eczema? Horrible pics attached!

[EczemaOrNot]

Had eczema on my foot for months. I have pompholyx triggered by allergy. I was exposed months ago and it triggered a flare on my foot and hands. It would not settle with my normal home self help and the foot eczema in particular was way worse than normal and looked quite different to normal flares.

Saw GP and now been on steroid ointment for about 2 months and the foot eczema is getting worse if anything. It keeps looking like it is getting better then worsens. Rebooked an appt with GP today but can’t see him for 2 weeks and have now noticed it has spread. Is hot to touch and is burning. Had burning before with eczema so could just be that but with it not responding to steroids am wondering if something else going on. Pics of foot attached.

Thank you

Trying again to post pics…

Have you had a biologic? Dupixent or the newer one Ebglyss? Also the efficacy of JAK inhibitors for AD is very good. There are some risks but not if you’re otherwise healthy as far as I know. Worth asking your dermatologist about these.

Looks very sore I'm prescribed steroids as well for mine and inbetween use have Avenno Cream .
Are you using anything like that to moisturise ?

Besides steroids, Child’s Farm moisturiser (for babies) is the only thing that cleared my kids and husband’s eczema reliably. It’s amazing stuff.

I would be asking for the GP to either contact Dermatology for specific advice (which can be quite quick) or for urgent referral.

You've probably read all this but : https://www.nhs.uk/conditions/pompholyx/
might have some advice

Personal experience of eczema is that it's really personal and that different things work for different people .

Things that have helped personally

dead sea salts - you could try a foot bath with them in. I would start with a very weak solution just to check if it causes more irritation
Equally oats in a sock in a foot bath (colloidal oatmeal) - can be quite soothing
Moisturisers with minimal ingredients - 50:50 is oily but worked well and you only need a little bit - as usual patch test
Doxycyline was helpful, but might not be with dishydrotic
Fexofenadine helped a small amount with the itching

There are some good eczema websites and /or forums that can be really good for advice.

Thank you. I don’t have a dermatologist, just under GP at the moment. I am also not “otherwise healthy”. Have a couple of autoimmune conditions, but if GP can’t resolve then I’ll ask for a derm referral when maybe these options can be discussed. Thanks for your reply and information.

@Jennalong@2pence. Thank you. I have allergies to things in a lot of creams (cetearyl/stearyl/cetyl alcohol being the one often used in creams) but I have a moisturiser can use (Bioderma atoderm) and probably haven’t been applying that enough so I’ll up that and see if makes a difference. Thank you.

Thank you I’ll try some of those options. I’ve seen on some eczema websites potassium permanganate soaks recommended, does anyone have any experience of those?

You mention that you have several autoimmune conditions. Have you been tested for Lupus? It's also an autoimmune disease, and can run hand in hand with other autoimmune diseases. My Mum has Lupus and it effects her skin. I think you need a referral to see a dermatologist.

Ask for a biologic…dupixent(dupilumab) would be your best bet.

@EczemaOrNot Way back when I started nursing I used potassium permanganate on wounds. Haven't seen it used for a while.

It stains though - it's a lovely purple and this can make the wound/skin harder to assess.

https://www.nursingtimes.net/tissue-viability-and-wound-care/should-potassium-permanganate-be-used-in-wound-care-05-08-2003/

Discussion of potassium permanganate

@EczemaOrNot I had something that looked very similiar - hundreds of tiny painful blisters. GP also thought pompholyx and I was prescribed numerous different steroid creams etc and none of them helped. I suffered for well over a year. I also tried the potassium permanganate soaks and whilst it provided some relief it was only temporary. I paid to see a private dermatologist in the end and he said let's go back to basics and treat as a fungal infection - I was prescribed terbinafine in tablet form for 3 months. I recall I needed an additional 6 week dose but I've been fine since.I was very sceptical but after a couple of weeks I saw an improvement and the tablets worked! My foot looked just like yours and honestly, it really affected me. It was worse at night when I got into bed so it affected my sleep and so so painful, hot and itchy. Even now a few years later I still thank my lucky stars that it hasn't come back. Worth asking about - I hope you can get it sorted.

I also then used Lamisil Once once a month for a while as I was worried about it coming back. You could try that but I think if it is a fungal infection you'd need the tablets due to severity.

I'm shocked that you haven't been referred to a dermatologist.
It looks awful and must affect you so much.
My partner has eczema on his feet and I know how he suffers
Your skin looks much worse.

Been to pharmacist yesterday and told him all the creams/remedies I had tried for DC. He (the pharmacist) had it on his foot and used Sudocrem for 4 weeks.
I thanked him but was secretly sceptical.
But have only been using Sudocrem for 24 hours on DC and the difference is amazing.
It is also only £5.60 for a massive tub.

Apple cider vinegar soaks have helped my pompholyx/ contact dermatitis alot

I tried steroid cream & several other different creams but found Bria Organic Balm the only thing that worked for me on my (comparatively mild) facial eczema

Thank you for your post. That’s really helpful and I’ll mention this to the GP.

Thank you but am allergic to Balsam of Peru which is the key ingredient in Sudocrem sadly 😩

Ah thank you. Yes it’s bad but tbf to the GP I’ve only seen him once (as I tried things at home first and I have a lot of health issues and am back and forth to appointments so it took me a.while to get in for this) so they normally want to try the “normal” things first which is probably fair enough. I’ve now booked a further appointment but it’s but for two weeks so wanted to get some thoughts and ideas from MNetters in the meantime. If the GP is out of ideas I’ll push for a referral/for him to ask advice from derm team.

No I haven’t but I’ll bear that in mind. Just being tested for Sjogrens at mo 😞

Sounds infected to me if it’s burning. Are you using the steroid religiously? I’m on a JAK INHIBITOR but steroids are still the only thing that clears it fully

Thank you but am allergic to some of those ingredients.

Also you really need to fight to get referred to a derm. Tell them it’s affecting your sleep or your sex life and it knocks your EASI score higher so they can refer. God knows why those are more important than ‘I want to rip my flesh off due to itching’ but apparently they are.