skin problem

[Guest guest]

Hi All,

 

 

 

I have a peculiar and puzzling skin problem that I'd like help with. Every

summer, after it's been hot and humid already for a few months, the skin on the

palmar side of the distal phalanxes of my fingers disappears, as if it

evaporates slowly over a few weeks. It doesn't peel, it doesn't flake, it just

disappears. It starts in the center of the pad of one thumb, then on the other

thumb a week or so later. The next fingers to do this are the middle fingers,

and then finally the forefingers. The ring fingers and pinkies are never

involved. As the skin exfoliates, the exposed area is tender, dry, very deep

red at times, and quite sensitive - especially to heat. Sometimes the exposed

areas resemble a geographic tongue without a coat, all pebbly-wrinkled and

lacking substance. I should mention that the fingers in my hands swell on and

off during the summer, making wearing my usual rings a little difficult at

times.

 

 

 

The skin will initially become dry and hardened, and then a naked (exfoliated)

spot appears. It will grow outward in a more or less circular pattern, and

eventually an irregular oval covers the entire pad of the phalanx. All along

the circumference of the exposed skin it is often deeply and brightly red, and

most tender. Often new skin will start to regrow where the exfoliation began,

before the rest of the phalanx is denuded. Sometimes the phalanx will start to

exfoliate all over again - either the newly regrown skin or a deeper layer

beneath the first, which is particularly painful. This disappearing of skin can

recur several times before it spontaneously discontinues. Sometimes it will

completely heal over before it begins again a week or so later.

 

 

 

This year, I moved to a new climate - high desert. Previously, I had lived all

my life near the Atlantic and Pacific oceans, and I expected it to be less humid

here in the summer than by the sea, but to my surprise it isn't. This skin

problem started about 7 years ago when I relocated to San Diego after living

many years in northern California. Every year, it would show up in July and

subside around September or October. I thought the new climate was going to

enable me to escape it this year, but it just showed up later than usual - a

couple of weeks ago.

 

 

 

Clearly, there is an element of dampness (hands swelling and worse in humidity),

a component of heat (deep redness and worse in summer), and also, puzzlingly, an

aspect of dryness (better with moisturizer at night). If I don't put

moisturizer on my hands before I go to sleep, I will wake up in the middle of

the night with my hands feeling hot, dry, swollen, tight, and painful - not just

the areas of the skin problem, but the entire hands, fingers in particular.

Often I will need to put on more moisturizer in the middle of the night, but I

never need it during the day. Usually I don't like using the feel of

moisturizers on my skin. Oily herbal preparations make the exposed skin even

more dark red and tender. Could this be a manifestation of yin deficiency heat

- heat in the five centers (hands, particularly), aggravated by hot weather? I

don't have heat symptoms like this anywhere else, though I am much more

frequently uncomfortably warm since moving here, especially in early

evening, which is oddly also our hottest time of day.

 

 

 

Also, while the skin on the palm side of my fingers is disappearing, I have a

few patches of " excess skin " on the back side of my hands - psoriasis; this is

present all year and sometimes itches.

 

 

 

I don't use any different skin products during the summer than I use the rest of

the year, so it's not an issue of seasonal exposure to something. If anything,

I use fewer products during the summer. In particular, the dish soap I use

year-round irritates it the most but only while the skin condition is present,

and sometimes I will wear gloves when washing dishes in the summer to prevent

this, but this year I haven't worn gloves at all.

 

 

 

I'm 49 years old, still (!) perimenopausal with regular, scanty periods that are

starting to come at longer intervals (31-34 days). In general, I have a spleen

qi deficiency damp constitution with stagnant liver qi and also blood deficiency

and stagnation (varicose veins). Kidney and lung qi, and kidney and stomach yin

are a little deficient. All my life I had been cold, until the last couple of

years. In western medical terms, I have a history of airborn and food

allergies, asthma (in cold air), eczema (in hot and extremely humid weather),

frequent strep throats as a teenager (with lots of antibiotics), mononucleosis

in my twenties which knocked me on my butt for many years with fatigue and

lowered immunity, and fibromyalgia since 1978. GERD and irritable bowel

syndrome have been resolved for over 10 years.

 

 

 

Pulse has always been rapid. Used to be 104 beats/minute until using TCM, now

is about 90-94, with extremely low blood pressure all my life (80/50). Pulse is

typically weak, medium depth, soft but sometimes slippery. Slightly thin and

slightly wiry on the left side.

 

 

 

Tongue is pale, slightly dusky, puffy, slightly scalloped with a few superficial

transverse cracks in the center. Sides are bare of coat and pale, tip is

slightly red. Coat is thin, white and slightly greasy.

 

 

 

Hot, damp, and yet also dry. Any clues about diagnosis and treatments (internal

and topical) would be greatly appreciated.

 

 

 

Thank you,

 

 

 

 

 

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