Any help for knuckle ulcers?

[tall-tim]

I have infernal ulcers about 4 mm across on the main knuckles of both index fingers; the finger is becoming crooked, looking like a red camel's hump with a yellow crater on top that reaches as far down as the joint capsule. I am dressing it with alternating manuka honey and Bactroban ointment, with honey gauze and cotton dressing strip on top.

If you know this problem, do you have any management advice to share, please? I'm having difficulty holding things, and the swine are disturbing my beauty sleep.

[Dodgegirl50]

I used to get ulcers but they did stop over time but yours sounds like R. Arthritis. Do you have that too?

[Amherst]

Oh yes I can sympathise! Firstly are you on antibiotics? Have you been offered an iloprost infusion? I am assuming that you are under a consultant rheumatologist and should therefore have access at least to the specialist nurse at the hospital. These ulcers can go on for months but the main thing is to stop the infection. They are so painful as you know especially at night and in the daytime the finger with the ulcer on is always the one which gets knocked. If you would like to discuss do call my helpline on 07530 810 964. If I am not available leave your number and I will call you back.

AM

[JoyBeHappy]

Hi. I have the same exact thing on both my hands. My ulcers opened and are beyond painful. I treated them by soaking my hands in water and hydrogen peroxide, drying them with a clean towel and the applying bacitracin and Bandages. This seemed to work for a while but they became infected. I was put on an antibiotic called Cephalexin. I had to stop the Myfortec for the Scleroderma to fight the infection. Please go see your doctor and have he/she exam the ulcers. They can be serious. Also if your skin is very tight, keep it moisturized.

[tall-tim]

Hello All.

Many thanks for your thoughts and queries. I am avoiding getting too involved with doctors and consultants, as I don't think my system is strong enough to deal with inevitable side effects of various medications e.g. iloprost and immunosuppressants. I'd prefer to see nurses in the local clinic who have a good practical outlook; also critical support from a homoeopath. I went to see her yesterday and she pointed out what I couldn't see clearly, that the swelling was an infection rather than autoimmune inflammation. Her suggestion is shifting the problem using hot salty water backed up by alternating Hepar Sulp and Silica remedies as well as continuing use of the Bactroban and manuka honey ointments and dressings. I think I need to be more proactive about infection control. Hadn't thought of hydrogen peroxide - might be combined with the salt.

[tall-tim]

The outcome - update December 2014.

I now have both middle fingers swivelled round at 90 degrees, permanently stuck there. The ulcers have dried up, thanks to Sildenafil (one pill a day) to improve peripheral circulation. X-rays show that the joints are not damaged, so I suspect that the ulceration destroyed the tendons on the upper side of the finger while calcinosis stiffened up the connective tissue of the tendons on the underside, causing the fingers to swivel downwards from the knuckle. None of my gloves now fit me!

The NHS has kindly paid for some finger braces which I can strap onto my fingers at night. If infection recurs this should stop the index fingers from following suit. The idea was initially to try to pull my fingers back into line, but I now think it's impossible - bolting the stable door after the horse has gone.

I think I might now be classified as disabled.

Ho hum...