What is this insignificant but persistent skin condition?
March 14, 2022 12:19 PM   Subscribe

My knuckles on both ring fingers are a bit scaly. What could be causing it? Details inside.

YANMD, but I'm insured through Kaiser and my doctor has been pretty uninterested in helping resolve this issue for several years.

What It Looks Like

Basically, the skin is a bit calloused, so the knuckle skin has no detail at all (there's no knuckle "print" in the skin, if that makes sense). The left knuckle is more serious, so untreated it tends to look like a red patch in the shape of a circle about 1/2 inch diameter. The right knuckle is less noticeable, smaller, and mostly just dry skin that flakes a bit.

What Has Not Worked

1. A steroid cream my doctor gave me a few years ago.

2. Aveeno (the eczema kind and the oatmeal kind)

3. Eucerin UreaRepair Plus

4. Bag Balm "Daily Moisturizing Hand Lotion (Jojoba and Shea Butter)" in a squeeze bottle

5. Changing what I wash my hands with

The only thing that comes close to working is the OG Bag Balm in the tin. I wouldn't say it "resolves" the issue, as in, the knuckles don't look totally normal and if I stop using it, the issue returns to the baseline condition within 36 hours. But, if I apply it three times a day, the fine lines on my skin start to return, and the red coloration fades a bit.

This has been going on for more than five years. It does not hurt, my doctor remains unconcerned about it, but if I could actually just have all my knuckles look the same, I would definitely prefer it.

The weird symmetry (identical knuckles and nowhere else on my body) makes me think it's some kind of minor systemic quirk or something. Any thoughts on what this is or what might fix it?
posted by kensington314 to Health & Fitness (13 answers total) 3 users marked this as a favorite
Response by poster: I feel like I left the actual description a bit too complicated. It looks the way I described, and it feels dry and scaly.
posted by kensington314 at 12:27 PM on March 14, 2022

Best answer: You may want to try a "bleach bath" for eczema. For a tiny batch, do 1 tablespoon (5.25% sodium
hypochlorite bleach) in 2 gallons of water, or about 1 teaspoon and a drip to a half gallon of water.

I've never been successful in fully making my single knuckle-patch go away. It seems to come and go with stress. I have done the bleach bath when it gets especially thickened and that has helped, and I seem to get decent relief from my go-to CBD salve, which is spendy (but worth it!!) so you could try their roller or tincture and then cover with any protectant like aquaphor or vaseline.
posted by Lyn Never at 12:41 PM on March 14, 2022

Best answer: I’ve had luck with the eucerin eczema cream with oatmeal and the unscented soap from simple human to clear up what I presume is eczema after I had an allergic reaction to soap. It may be trial and error and constantly applying product. You can also get a second medical opinion.
posted by Crystalinne at 12:55 PM on March 14, 2022

Do you wear a ring on your left ring finger?

If you do, or even if you did when it started but don’t now, I’d guess you’re reacting to the metal in your ring.

And the patch on your fight ring finger is the mirror reflection reaction which is common for things like poison ivy and is almost inevitable with my psoriasis, for example
posted by jamjam at 2:00 PM on March 14, 2022 [1 favorite]

Response by poster: I do not and have never worn a ring.
posted by kensington314 at 2:13 PM on March 14, 2022

Do you unconsciously rub it, chew it, or otherwise irritate it? I'm a little embarrassed to admit that while working I sometimes unconsciously chew my fingers. Even if it doesn't hurt and even if I catch myself and stop before I've been doing it for too long, eventually my skin gets oddly calloused. Your description sounds a little bit like the strange calluses I have on my hand from this frequent low level irritation. So is there any chance that particular nuckle is getting rubbed, chewed, or otherwise irritated?
posted by Tehhund at 2:26 PM on March 14, 2022

Best answer: Try an antifungal, 2 or 3 times a day for at least 2 weeks, and see if it changes.
posted by Pallas Athena at 2:38 PM on March 14, 2022 [1 favorite]

I had red, sometimes scaly and itchy patches on my thumbs in also weirdly symmetrical areas. A dermatologist diagnosed it as psoriasis, but nothing ever worked on it. Aveno moderated it a bit, but never cleared it up.

My wife got me a sampler set of this soap for my Christmas stocking this past Christmas and after a couple of weeks of using it as my daily shower soap I just happened to notice that my hands were completely clear, and have stayed clear. It wasn't a double-blind study, but nothing else about my daily skin care routine changed.

So I've ordered full sized bars of the soap. It smells good, and my wife says my skin is softer, so it's a win, even if the stuff on my thumbs eventually comes back.
posted by COD at 4:11 PM on March 14, 2022 [1 favorite]

Response by poster: COD, which one was it specifically? This is an interesting and actionable suggestion.
posted by kensington314 at 4:14 PM on March 14, 2022

Response by poster: wait nevermind COD, I do see elsewhere on the site where the sampler is.
posted by kensington314 at 4:16 PM on March 14, 2022

If this condition persists and your insurance will cover it, see a dermatologist. I had a strange skin condition a few years ago - my primary care physician was vague but kept diagnosing it as a yeast or fungal infection. None of the antifungal creams she prescribedhelped. Finally got an appointment with a dermatologist who said, nope, not fungal and got me a diagnosis and treatment that worked.
posted by See you tomorrow, saguaro at 6:41 PM on March 14, 2022

I do agree it's worth a quick look with a dermatologist. If it's psoriasis - which doesn't normally present in such small static patches but can definitely pretend to be unremarkable - you'll want to keep an eye out that it's not quietly eating away your joints in a way that you will not start to register until the damage is very done. And definitely if you happen to have stubborn "dandruff" or red/itchy scalp patches, get your GP to order bloodwork that includes inflammation markers and see if you need to skip the dermatologist and go straight to the rheumatologist.
posted by Lyn Never at 6:46 PM on March 14, 2022 [1 favorite]

Try MG217 coal tar ointment. This sounds like a mild case of psoriasis to me: eczema is usually more likely to present within the creases, not on the “exterior” of the joint.

If it works, use it as little as possible. You should only need a tiny dab each time you use it. Psoriasin ointment is also OK; I just think the MG217 one is superior.
posted by verbminx at 10:48 PM on March 14, 2022

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