Suggest Treatment For Discoloration Of Numb Right Hand Thumb

Posted on Mon, 17 Mar 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 17 Mar 2014 Answered on

Mon, 7 Apr 2014 Last reviewed on

Question : Hi Doctor, My sister who is 30 years old and mother of two child. This morning top skin of her right hand thumb started becoming in a different colour (like dead skin) and she can't feel touch on that skin. By evening it expands and reach till the wrist but only only on the top side and from the side of the thumb. Earlier, she faced problem of lesser blood in the body and doctor has suggested certain diet to gain more blood. Please suggest, what could be the reason. Thanks and regards, XXXXXXX

Answered by Dr. Dr. Kakkar (24 minutes later)

Brief Answer: Moisturizer+Topical Steroid (mix 1:1 and apply) Detailed Answer: Hi. Thanks for posting your concern at HCM. I am Dr. Kakkar. I have gone through your concern and I have understood it. I would keep a possibility of Chronic cummulative irritant contact dermatitis. But, I would like to gather some more information from you in order to help you better. --Does she has any symptom like itching or pain at the site of lesion? --Does she engage herself in routine household work which requires prolonged contact with water, soaps, detergents, cleansers etc Extreme dryness can lead to chapping and cracking/fissuring of the skin of hands and feet. People who are atopic/allergic have a low water retentive capacity of the skin, which leads to increased trans-epidermal water loss into the atmosphere specially when the weather is dry and cold in winters. Repeated washing with soaps exacerbates the condition leading to painful cracks and fissures. In such a situation it is advisable to apply a good moisturizer as frequently as possible. Moisturizers specially those which contain hygroscopic (attract water from the atmosphere and lock it into the skin) and keratoloytic agents like Ammonium lactate, Urea, Lactic acid and Glycerin and Hyaluronic acid are specially useful in such cases. Moisturizers should be applied as frequently as possible, and each time after washing hands with soap. I usually ask my patients who are severely affected by dry, scaly and cracked skin to mix (in equal proportions, 1:1) a potent topical steroid like clobetasol cream and moisturizer and apply at least twice daily. Once the condition improves with this combination, usually within 2-4 weeks, only moisturizers alone would suffice. regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (11 minutes later)

Thanks for your prompt answer. Answer to your query: --Does she has any symptom like itching or pain at the site of lesion? Ans: No, there is no itching and pain. --Does she engage herself in routine household work which requires prolonged contact with water, soaps, detergents, cleansers etc Ans: Yes, she used to do day to day home maker activities and use water during cooking and washing clothes as normal. I would like to highlight that she is feeling numbness at those spot while touching those spots. If it due to extensive use of water, detergent etc. then it should be on the whole hand but it started with some portion of thumb and strangely it expands on some spot on wrist by the evening.

Answered by Dr. Dr. Kakkar (13 minutes later)

Brief Answer: Irritant contact dermatitis Detailed Answer: Hi. Chronic cummulative irritant contact dermatitis can develop as localized patches on the hand with areas of sparing. Itching/pain are subjective. --Can you upload a clear picture of the affected area for me to be able to have a look at? --Is the numbness persistent or is it only at times and then fine at other times? It could be because of median nerve compression/carpal tunnel syndrome thereby giving rise to numbness in that area..It is an entirely different problem for which you might need to consult an orthopaedician. regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar