Sunday, March 08, 2009


Last October, I noticed that I had developed what can best be described as a "Callous" on the ball of my right thumb. I ignored it, assuming that I had some kind of bacterial infection on the place where I used to put of the safety of my pistol and otherwise used during shooting as part of my unique grip on the pistol.

The dry skin condition continued for a while, and spread to other fingers in my right hand (my "Strong Hand").

A week after this appeared, I managed to knife a hole in my left hand while boning chicken for dinner. Within a few days, this area also demonstrated the 'callous' appearance.

For two weeks, I watched the "infection" spread from my thumbs to my index finger, and then to my middle fingers.

I mentioned this to The Hobo Brasser, who affirmed that he also from time to time discovered a similar skin infection on his fingers. He mentioned that he got a prescription from his doctor for 2% Hydrocortisone ("anti-itch") creme. I had been wearing bandages to protect the infected areas, and that solution was unsatisfactory. Every time I went to a match, the mechanical interaction between the pistol (especially racking the slide) exacerbated the condition. So I began treating myself with over-the-counter 1% Hydrocortisone cream.

That made me more comfortable, because my fingers were not as painful. But it did't stop it from spreading, let alone cure the uncomfortable condition.

(As my hands dried out, the affected area of my skin spread and the center of each infection split. This was similar to a paper cut: a minor wound, but the outer layer of skin sloughed off exposing the nerve endings on the 2nd layer of skin, making it very tender. For example, it is difficult to perform such simple everyday tasks as buttoning a shirt, putting your hand into a pocket, or typing on a keyboard. Bandages only make your fingers more clumsy, and it's hard to 'touch type' with bandages on.)

So I went to my doctor.

My initial complaint was "Eczema", which he decided was probably due to a fungal infection much similar to Athlete's Foot.

My doctor (during a period covering not days, or weeks, but months) prescribed the following treatments:
  • an anti-fungal cream (not available over-the-counter) but in a 1 ounce tube, which was used up after the first week.
  • "Fluocinonide", which is a steroid cream (applied topically, similar the the Hydrocortisone and the prescription anti-fungal cream) in 2 ounce tubes, with two refills.
  • a new 'systemic' drug: "Ketoconazole". I took one tablet a day for 14 days. At the end of two weeks, my infection was much less obvious and it didn't seem to be spreading. But it wasn't killing the infection.
  • Prednisone. I take 3 tablets in the morning after meals for three days, then two tablets for three days, then one tablet for three days.
  • He also suggested that I get some Lamisil, which is an over-the-counter remedy for Athlete's foot. We're still working under the presumption that this is a fungal infection.
  • During that evaluation, the Doctor took scrapings of the infections. His lab reported NO sign of fungal infection. He had cautioned me that fungal infections don't always find fungus from scrapings because the actual fungus may not be evident on the surface of the skin. Interpretation: he still doesn't know what causes this condition.)

(I have continued to treat my hands four times a day. I put down Lamisil as a base coat, then when it dries I cover it with Fluocinonide. When that coat dries I apply Hydrocortisone to protect the active ingredients when I wash my hands. And at night, when I go to bed, I continue to apply Neosporin to help heal the split skin and protect the lower layers. Overkill? I think not. At least some areas are still healing, but not 'healed'.)

Saturday was my second day on this regimen. I taught a class on Introduction to USPSA. I was out in the weather (cold, but dry) and I was fairly comfortable because the worst of the infected areas were not 'active'.

Until I put on gloves to protect my hands when I put the props and targets and stands away. In a half-hour I had new areas of dry-skin callous on my fingers and thumbs, and three of them demonstrated split skin. I have no way of knowing whether it was because the gloves provided a warm, damp environment which encouraged the infection to grow, or because the abrasion between my fingers and the gloves caused the situation to worsen. (I am unable to find the correct terminology, because I don't know WHAT is causing this situation.)

During the class, I 'drafted' an experienced USPSA competitor to help me as a demonstrator. When we were talking, I noticed that his hands, too, exhibited the typical scaling of skin on his fingers. I mentioned it to him, but we didn't have time for me to discuss his experiences with scaly skin and splitting callouses.

This was the second USPSA shooter I've met (besides The Hobo Brasser) who had the same condition which has been haunting me for the past six months ... most of that period I have been under the direct, concerted care of an experienced physician. He doesn't know what is causing it, he doesn't know how to treat it, and my guess seems to be as good as his, so far.

I'm beginning to wonder whether this is a condition which is common to IPSC/USPSA competitors?

This evening I was exchanging email with Bill S., who reports that he is inflicted with this skin condition every Spring, and he has for years.

So there's me, there's The Hobo Brasser, there's Bill S., there's Aaron (the demonstrator) , and there's a Geek in my office who have the same skin problems.

The following photos depict the BEST my hands (fingers) have looked in the past 5 months.

Picture #1: Right thumb. You can see the dried "callous" appearance on the pad of the thumb. This is very sensitive, and when environmental conditions are less than optimal the dried area increases in size, and the skin splits horizontally. This can occur within a matter of less than an hour.

Picture #2: you can see that the little finger has a small patch of skin missing. This area is not physically in contact with any other infection, because the ring finger shows no sign of infection.

Picture #3: The left thumb is strongly infected. The left index finger is partially infected (down to the second knuckle) and the left middle finger is lightly infected. The infection is indicated by small areas where the first layer of skin is missing. Left untreated, these areas will exhibit signs of "Callous".

Picture #4 Right Fore-finger ("Pointing Finger"): this finger exhibits the typical 'scaling', where the first layer of skin remains in patches, and is surrounding by the second layer of skin. This seems to be representative of cases where some treatment has been applied, but with limited success. Note that when treatment has not been attempted this 'scaling' is dramatically more pronounced.

Most of my readers are IPSC/USPSA competitors. If you have the same condition, I wish you would write to let me know about it. Is this a long-term, repeating condition? How long? How are your symptoms the same, or different, from mine? What does it look like? How have you treated it, and how effective has your treatment been? Have you seen a physician, and has he diagnosed it as a Fungal infection, or something else? Has he prescribed a remedy, and has the medication proved effective both in relieving your skin condition and preventing it from spreading?

I'm more than a little worried. In recent weeks, the infection on my right hand has skipped the Ring Finger and started in on the Little Finger. Why? I've assumed that the infection has spread from each thumb to the adjacent Index Finger and also by contact from the Index Finger to the Middle Finger. But this has skipped a finger, and I don't know why.

(I feel so lame whining about skin conditions, but it has affected my ability to enjoy my favorite participatory sport ... Practical Pistol Competition ... and also my profession as a Computer Applications Programmer, so it's more than an inconvenience. It's debilitating.)

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