A set of female hands, the left one covered in spots

Not Happy About My Hands

When I was dating, I often tried to hide my left hand under the table when we were sitting at a restaurant or in other places. The hands are a bad place to have messed up skin, because you have to look at them all the time. The women of my mother’s generation, who wore gloves, had the right idea. They could protect their skin while looking elegant.

The greater damage to my left hand is most likely due to sun exposure when in the car. The right has similar problems but not as much. Little bumps and spots have different origins. When zapping them, my dermatologist calls them “the little guys.” One spot has lost pigment due to another dermatologist’s freeze.

My skin makes me self conscious

I’m probably making it sound worse than it is. But when you have a skin problem that makes you self conscious, that’s the way it is. You might feel like your skin is screaming out, “Hey don’t look at me, I’m gross,” while other people might not even notice.

I’ve treated them several times with Efudex and each time they do calm down. Then something pops up again. Most recently I treated with Efudex and Calcipotriene (Dovonex), a synthetic vitamin D3 derivative. The combination has been shown to be more effective at getting rid of actinic keratoses than Efudex alone.1

I try to follow doctor’s orders. But I couldn’t do what my dermatologist said to do: apply with occlusion. By that, she meant to seal the cream in with plastic wrap, for about half an hour or so. I wrapped my left hand but the darn stuff wouldn’t stay on. I tried it for a few minutes. It felt like a paw.

I tried a different way

Since it was falling off anyway, I put on the exam gloves that I’ve used before. I’ve done it in different ways, either sleeping in the gloves or wearing them for a period after the application. As I’ve written, I get different instructions from different doctors, so, in addition to being embarrassed, I am also confused.

A look at my Patient Gateway dermatology summary sent me to Google. I don’t usually look at the summaries, but for some reason, I clicked on the one after my last dermatology checkup. I found out the official name for some of my newest aggravations.

The summary read, “You saw Jennifer Y Lin, MD on Tuesday August 27, 2019. The following issues were addressed:

  • Actinic keratosis
  • Neoplasm of uncertain behavior
  • Non-melanoma skin cancer
  • Verruca plana
  • Xerosis cutis"

What are my spots?

During the examination, the resident in the room said that some of my spots look like warts. I get them from being on prednisone, which inhibits the immune system so that viruses (like warts) can sneak in. Lo and behold, Verruca plana are flat warts.2

And what about neoplasm of uncertain behavior? It means a growth that is benign but that could turn malignant.3

What else?

“Xerosis cutis” sounds like maybe she thought I looked cute.
It is, however, the term for abnormally dry skin.4 It is mostly a problem on my legs. She said to get AmLactin, which used to be prescription but is now over the counter. It feels kind of yucky, so I mix a little body butter in with it.

When the dry skin clears up, she wants me to go after the AKs on my legs with Efudex. At least I’m not always looking at the xerosis cutis on my legs the way I look at the Verrucca plana on my hands.

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