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Maybe It's Hand P and Maybe It Isn't
from Holly D.

Hi. My name is Holly. I've been logging onto your site since my father (who has had P since 1967) told me about it. It's been a constant help for me to find a way to smile when I think I've got it bad. I have fairly mild P, with the majority of it on my scalp, which is more annoying than anything else, and some spots on my legs and elbows, which garner more pity than I can stand. I've had it for about 5-6 years, with small plaques popping up now and then.

The question I have is actually that my hands have recently become very rough, like I have callouses. I don't do physical labor (I'm an operator for the local phone company) so I don't know what the deal is. I have small spots of dead skin showing up all over the place: very itty-bitty spots. Mainly on my fingertips. I've been lotioning like mad, which doesn't do anything to stop the mass exodus of skin from my hands. I was just wondering if this possibly has anything to do with P and if there's anything I can do for it. It doesn't seem to look like the plaques on my legs or scalp, and it doesn't itch, either. So maybe my hands are just growing?

Currently, I don't do a lot of preventative maintenance with my P. I use T-Gel or the like on my scalp, and my legs and elbows just get the occasional harassment from my nails. Any help I can get would be appreciated.

Thanks for your time, and thanks for having such an awesome site. It's totally cool that there are people out there that have a sense of humor about something that is a total drag. Thanks again. -Holly D.

P.S. I'm sorry to hear about Clara's diagnosis...I wish you both the best.


Ed's Response: Welcome aboard, Holly. (Tell your Dad he must call to get his new member finder's fee.... And we'll want proof that you did not log on under duress.)

Reading your description of your hands phenomenon took me back a few years. A derm will have to eyeball what's going on to tell you whether or not the problem is P. But I had pretty much the same symptoms (and the same doubts). Finally I was told my hands had P but of the "pustular" as opposed to "plaque" variety. At first there were large "puffy" spots on the palms of my hands and something that looked like pimples on the backs of my hands. The palms dried up eventually and the skin over what had been "puffy" turned into whitish scale. The backs of my hands developed the more recognizable red lesions (with pronounced borders) and the pimples remained inside the red lesions. It was an interesting geography, to say the least.

On the other hand, the lesions on the backs of my hands did itch. Itched to distraction, in fact. But this was only after the lesions had matured several weeks.

The good news is that I've found the hand P to be among the most responsive to occlusion therapy. No matter how bad the hand P has become, three or four successive nights slathered in a Group 1 (potent) corticosteroid, then wearing food handlers' gloves taped tight at the wrists will bring about an impressive remission. Doesn't always last too long, but ... hey ... one takes what one can get!

Watch out for cracking lesions on your hands. Sounds like your situation isn't that bad and I hope it stays that way. If the lesions develop cracks they may hurt like hell, which should alert you to take action against infection. If you haven't already, you may want to read my (timely) article written three years ago: Hands at Halloween.

Your use of the term "preventative maintenance" gave me pause. All of us engage in it in some fashion, but the derms don't refer to any of the regimens as "preventative." They are all "palliative," meaning they are applied after-the-fact to try to control symptoms. After the lesions on my face cleared up and had been in remission for over a year, I told my derm's physician assistant that I used Westcort cream (a mild topical corticosteroid) on my face where the lesions used to be—"as a preventative." She chewed me out pretty good; suggested that if there were no active lesions I should not be putting corticosteroids on my skin. I hadn't laid off for a week before I saw the lesions forming on my nose and forehead again. Now I just don't tell those people about my preventative maintenance regimens. -Ed

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