ulcerated finger tips

[aramaya]

I have ulcerated finger tips, with horrible crusts. Does anybody have any suggestions on how to remove these awful crusts...they are very painful and keep snagging on material etc.. I have had Scleroderma for over 20 years, but this year is the worst its ever been...ANY topical creams out there, or do i just keep them covered?

[Lyndabickley]

Hi Aramaya

This happens to me a lot too. As well as occasional infusions of Iloprost I have been prescribed sildenafil to minimise the ulceration. It's worth checking with GP whether the ulcers are infected. You may need antibiotics. There is also an antibiotic cream that can be used. Otherwise I keep my hands moisturised with cocoa butter and cover the ulcer. There are also a number of dressings which can be used to soften and remove the crust and then a different kind (inadine) to facilitate healing. Your practice nurse should be able to help with this. I have a range of dressings and usually manage myself having been prescribed the dressings but my rheumatologist was concerned that I should have medical input whenever my skin was broken. Hope you can resolve this.

[aramaya in reply to Lyndabickley]

Thank you....definitely need GP intervention for mine...and will discuss the medication you take ....thanks again.

[Patatie50 in reply to Lyndabickley]

Hi Aramaya, What meds are you taking to deal with your problem? Do you have Raynaud's? I've had this for 19 years. No cause was found. My Rheumatologist put me on Procardia XL (60 mg) and Vasotec ( 40 mg). After the first 2 years, he reduced dosages to 30 mg Procardia XL and 20 mg Vasotec which I continue to take. In the beginning, I wrapped each fingertip with bandages on which I applied Neosporin. Very messy but it helped. Later, I replaced Neosporin with Vasaline (not quite as gooey). I was teaching school at the time, outside often (recess duty). Placed warmers in my gloves and shoes. Spent a small fortune in hand warmers, and products to moisten my fingers and hands, but it was better than the alternative. My routine was to always carefully wash hands in warm water, dry thoroughly, add a medicated moisturizer. At night, I put Vasaline on my digits, wrapped each finger and toe in band-aids and wore white cotton gloves on hands, cotton socks on feet. Not a great procedure to go through at night, but over time eliminated the crusts and bleeding ulcerations on fingers and toes. Tip of nose is my other problem area as there is no way to wrap the tip of nose. I just coat the tip with vasaline whenever I go outside during inclement weather. Not great, but helps. For my case, the key was the combination of Procardia XL (60 mg) and Vasotec (40 mg) daily plus pampering my hands and feet. Procardia seems to be a popular medication of choice with many Rheumatologists. Perhaps asking to add that med. to whatever you are taking for scloderma. No one told me to do this vasaline treatment. I tried the Vasaline after using many, many, many varieties of products. Nothing helped better than good old Vasaline. Using the wrappings, bedtime gloves and socks, plus warmers every time I went outdoors for about two years was tedious but it was worth it. At the beginning, while in hospital, a visit from the hospital amputologist was frightening. I had already lost the tip of my right index finger due to ulceration and gangerine and did not want more of that. So I pampered my fingers, and still do. Keep those digits warm in all weather...rain, snow, sleet, cold damp days,etc... even if the rest of you gets hot. Be patient. I've been dealing with this a long time. Winter and spring are the worst seasons for me. Hope this has been of some help to you.

[Glynis]

Hi This happens to me a lot, often resulting me having to take antibiotics for a few weeks, Last year I had two of the ulcers debrided as they weren't healing despite the antibiotics etc.,If yours are not healing speak to your rheumatology/sclorederma specialist about them , they may refer you to see a hand specialist to see if they can help.Hope you get some relief soon Good luck

[aramaya in reply to Glynis]

thank you.....fingers so painful...antibiotics also dont seem to work, and the crusty bits stay forever, so will ask for the procedure mentioned.....

[Duttie]

I think you need medical help. You could try your GP to see if the nurse could dress it, mine was very negative when I suggested this, his answer was antibiotics. But I was told when I was in Leeds to have it swabbed first. I don't know where you live, but Leeds have a brilliant ulcer clinic who will deal with these ulcers. I have now moved and am seen at Salford, however they don't have an ulcer clinic, I was referred to a hand surgeon, who offered to sever the nerves in my palm, I said no way. So I dress it myself and use the clinical grade manuka honey I was given at Leeds. Mine has been infected since Jan 2016, it has underlying calcium which I understand makes it very difficult to heal. If you get no joy from your GP I would contact your Rheumatologist. Best of luck.

[kimbalina]

Hi Aramya

I know what you are going through. I became so desperate as the pain of ulcerated fingers was unbearable. Mine have also been infected.

I went to see a Chinese doctor and she gave me ointment which is amazing. It is very oily and brown in colour so you need to place plasters or dressings over it.

The Chinese people use it primarily to treat burns of any description including chemical burns but it is also used to treat ulcers.

Jing Wan Hong Ruan Gao.

Look it up and read about it. You can buy it at any Chinese herbal shop.

Then once the ointment has healed the ulcers you can use corpitol emulsion which prevents reoccurrence.

This can be bought in Spanish pharmacies or on line. A lady on here recommended it god bless her.

Good luck and welcome to to certain relief!!

Kim

[aramaya in reply to kimbalina]

Thank you for taking the time to respond. I have made a note of your recommendations and will certainly try them. I will try anything to get rid of the pain and get healing..

[kimbalina in reply to aramaya]

I know it is unbearable and affects everything you do. Even showering and drying yourself is agony.

The good thing is the Chinese ointment takes the pain away the minute you apply it!!

[Lyndabickley in reply to kimbalina]

Hi Kim

Do you the Chinese cream on already ulcerated and infected ulcers or just when th y have formed a scab. It sounds amazing.

Lynda

[kimbalina in reply to Lyndabickley]

Hi Lyndabickley

Yes definitely on ulcers as the ointment takes the pain away and heals them.

It is amazing don't know how I would have coped without it.

Start using it the minute the ulcer starts. If it is infected you need ciprofloxacin antibiotics. But still use the Chinese ointment as well.

Kind regards

Kim

[cowhide]

I use good old fashioned Germolene cream to help heal and take the pain away from my ulcers (essential you get medical attention if you think they are infected though). Germolene acts as a local anaesthetic as well as being antiseptic.

[kimbalina in reply to cowhide]

Germolene helped but not anywhere near as good as the Chinese ointment.

[aramaya]

am off to purchase some this morning.......thank you

[MFC911]

Hi Aramaya,

In my experience having had the same problems for over ten years now. It is a question of finding the right way of dealing with it for your body.

What works well for one person may not nessecerly work so well for another. Like all things related to this diabolical disease it is a question of trial and error.

Although very tender my fingers are clear (touch wood) and have been for about a year. Previously I was in an awful state, sounds similar to you.

I am currently on 150mg sildenafil per day as well as warfarin, adalat and numerous other meds not so relevant to the ulceration side of things.

As far as actual dressing are concerned. What worked for me a got my finger tips back to as near normal as they ever will be, got rid of the scabs and sores in about a month or six weeks was:

Generous application of "Fucibet" antibiotic ointment covered with a layer of "Mepitel One" (I found that one 6x7cm cut in half was just right for two finger tips) on top of that a layer of Melolin taped on with "Micropore" surgical tape ( I was prescribed boxes of ten rolls at a time).

On top of that little lot a covering of tubular gauze again taped on at the base.

I know that all sounds like an awful lot of trouble. It is! After a few days you get the hang of it and can change the dressings quite quickly.

Don't get them wet! If you do change the dressing. You may have to put your foot down with the Doctor as that little lot costs a fair bit BUT IT WORKED! So, don't take no for an answer. Worth a try for a few weeks. Hopefully you will be impressed with the results.

Good luck with it. And, try and keep smiling. My God it is difficult sometimes. I know. Good luck once more. Mark.