Painful Bumps in the Hand: Is It Pompholyx?

Granules similar to pimples in the web of the hand?

Hello Doctor: A few months ago, I developed a bump in the webbing of my hand that looked like a pimple.
It was hard and contained pus, but I couldn't squeeze it out, and it was painful when pressed.
After seeing a doctor, they used a needle to puncture it and drained the pus, which helped the wound heal.
At that time, I asked the doctor if it was acne, but they said that area is not typical for acne and it seemed more like an infection.
There were also some peeling symptoms in the webbing.
However, yesterday, the same area developed another bump, but this time there was no peeling or wound nearby.
I would like to ask if this could be a form of dyshidrotic eczema? (Attached is a photo: https://lurl.cc/887Rx) Thank you for your response!

Tong, 30~39 year old female. Ask Date: 2024/06/12

Dr. Wu Yuxin reply Dermatology

Online diagnosis is not possible; it is recommended to seek an in-person consultation.

Reply Date: 2024/06/12

More Info

When it comes to painful bumps on the hand, particularly in the area you described, there are several potential diagnoses to consider. Based on your description of a hard bump filled with pus that is painful to the touch, it is important to differentiate between various skin conditions, including pompholyx (also known as dyshidrotic eczema), infections, and other dermatological issues.

Pompholyx is characterized by small, itchy blisters that typically appear on the palms of the hands and the soles of the feet. These blisters can be filled with fluid and may cause discomfort, but they are not usually hard or filled with pus. Instead, they tend to be more vesicular in nature. The condition is often associated with sweating and can be triggered by stress, allergens, or irritants. In your case, since you mentioned that the bump was hard and painful, it may not fit the classic presentation of pompholyx.

Given that you previously had a similar bump that required drainage and was described by your doctor as an infection, it is possible that you are dealing with a recurrent infection, such as a localized abscess or folliculitis. These conditions can occur when bacteria enter the skin through a break or hair follicle, leading to the formation of pus-filled bumps. The fact that you experienced peeling skin in the area previously could indicate that there was some irritation or a minor infection that predisposed you to further issues.

If the new bump is not accompanied by peeling or other symptoms, it could still be an infection or an inflammatory response in the skin. It is essential to monitor the bump for changes in size, color, or pain level. If it continues to recur or if you experience increased pain, redness, or swelling, it would be advisable to consult a healthcare professional for further evaluation. They may recommend a culture of the pus if it becomes necessary to determine the specific bacteria involved, which can guide appropriate antibiotic treatment if needed.

In summary, while pompholyx is a possibility, the characteristics of your bumps suggest that they may be more consistent with an infection or another dermatological condition. It's crucial to seek medical advice for an accurate diagnosis and appropriate treatment. If you have any further questions or concerns, please feel free to reach out.

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