Dear doctor;

Across the tops of my toes, the skin is very dry and blistery and constantly exuding a watery substance. It also seems to be spreading to other areas of my feet. It starts off itchy and I can feel little lump-like things inside the skin. The itching is driving me crazy but I’m trying not to scratch it so as not to spread it. This has been going on for two weeks now. What do I do?

James, 22.

Dear James, The way the condition of the skin is described seems that it could be eczematous dermatitis. Eczema is a condition of dry, itchy, thickened red skin with blisters. It usually occurs over hands, feet, face, underarms. There may be oozing from the blisters known as wet eczema. Itching also occurs over affected parts, Scratching may lead to secondary bacterial infection and  painful abscess. This problem occurs due to allergy present in the atmosphere or consumed as food or drink or applied over the body in some form. The  skin is hypersensitive and gets inflamed easily. Eczema develops for the same reason as allergic cold or asthma. One may have one or more of these conditions. Along with environmental factors, there is a strong genetic component that determines susceptibility to eczema. Some people get eczema with change of season, whereas others have it persistently.

Contact dermatitis is a condition where one can have a dry and red prickly skin after contact with an allergy producing substance. Soaps, detergents, and creams are the common substances producing contact dermatitis.

Psoriasis is another condition where the skin becomes itchy, scaly and dry, but the lesions are mainly on the posterior aspect of limbs. Chronic renal failure, cancers can also cause dermatosis similar to eczema but there would be associated features of the disease. Eczema is usually diagnosed by the typical skin lesions.

There is no total cure of the condition. In mild cases, use of emollient creams helps improve the condition. But in more severe cases, one has to use anti-allergy and even corticoid tablets. Antibiotics are needed in case of secondary bacterial infection.

Prevention of eczema lies in preventing the offending allergy producing substance, if possible.