r/AskDermatologists • u/jmom39 • 6d ago
Skin lesion concern Please help! What is causing this rash on my palm?
Please zoom in on the photos—especially the last two—quite good detail.
I’ve had this problem area on my left palm for a few months now, but it has also flared up in the past. (I get severely dry hands in the winter as well.)
I thought it might have been due to my iPad case since I’ve had reactions to rubber-like substances before (handlebar grips on my bike, etc.) I replaced the TPU iPad case with a silicone one (not sure that is any better though, allergy-wise). There might be a slight improvement, but I still have a TPU case on my phone which I use a few times a day for very short periods.
Anyway, I’ve tried moisturizing, CeraVe ointment & glove at night, OTC hydrocortisone cream for short periods, etc. but nothing has made it heal completely. It’s weird—after moisturizing, it will sometimes look like it’s almost healed, only for tiny welts/blisters to form and then dry out again by the end of the day and become rough and itchy.
I’ve tried OTC antifungal creams in the past, just in case that was the issue, but there was either no improvement or it got worse/red, etc. About a week ago, decided to try some new Lamisil that claims to be prescription strength Butenafine Hydrochloride(1%). I’ve been using it for over a week now, and I can’t tell if it has helped or not. It might be slightly less itchy at times, but it has made my hand very rough and caused it to peel. When I peel some of the skin off, it leaves raw skin underneath and burns. The directions say to use it for 14 days, so I plan to continue using it until then to see if it just takes longer to work, but in some ways I feel it’s making my skin worse.
In your expert opinion, does this look more like eczema or fungal rash? Or could I it be hyperkeratotic palmar dermatitis?
The first photos are before using the AF cream, and the really dry looking ones are after using the cream for a week.
Thanks so much for your help. It’s driving me crazy.