Have they ever biopsied it? It looks a bit like candida (athlete's foot), but I presume they'll have tried that.
The best description I've heard for eczema is that the only thing we know is that it isn't a steroid cream deficiency... But that doesn't help understand what it is.
There's a useful checklist I downloaded to help figure out the underlying cause for my eczema, and you can try it to work on your mum's:
Yes they have tried biopsy and other dermatology investigations and have not found anything of note. Hence I am thinking perhaps it’s thyroid related as she’s so under medicated and now has increased dose so let’s see.
I’m wondering if anyone else has had such severe issues of skin due to thyroid under treatment and if it resolved by increasing thyroxine.
Otherwise I will have to get her to see a private Dermatologist to get a second opinion.
I get pretty bad skin problems, and my legs get very nasty bleeding dermatitis on them if I eat gluten, which is also an intolerance common with hashimotos, so there are other possible causes relating to the disease.
I don't know that a private dermatologist will help where an NHS one hasn't been able to, they would tend to prescribe a steroid cream, and that may treat the symptoms but it won't treat the cause.
Whenever there is a skin issue, I think about posting a link to Dermnet NZ. Their library of photos covers an awful lot of skin issues - and, in particular, they have obviously tried to include multiple photographs to illustrate the range of possible presentations.
As it happens, when I went to the site, my browser opened the site on a page about Palmar Erythema. That doesn't look quite right to me, but would be something to consider and decide on.
Even modest hypothyroidism had an impact on my skin - dryness and hard, uncomfortable elbows which, although mild, started to crack very slightly. Anyone with thyroid issues is all too likely to have any of a wide range of skin problems.
Hypothyoid is unlikely to cause localised problems but it will impede tissue repair and cause dry skin, so it's important to be adequately medicated. Hypothyroidism also causes vitamin A deficiency resulting in carotenemia (yellow skin on palms) in severe cases. Vitamin A is needed for tissue repair so I would supplement just to make sure she is not deficient.
I was wondering about vitamin A. Years ago my son and his wife came to visit. She had a rash on her hands which wasn't responding to anything she had tried. I happened to have a vitamin A cream which I gave her to take away and try - it worked.
I just googled for vitamin A deficiency and one of the things that came up was this
Yes, or even cod liver oil is good although I feel the capsules should be banned so todays kids get to suffer like we did! The taste still comes back when I think of it.
I used B12 cream for my eczema and it cleared it up after using it every night before bed. It took a while but did go. I also had very bad pompholyx on my hands that was extremely embarrassing, B12 cleared that up too.
Nowadays I only have a small recurring patch now and treat it with this cream. It takes the itching off and clears up very quickly.Bought it on Amazon btw.
This looks like what I'm going through. I also have it on my shines and lower back Done biopsy last week. GP don't have a clue as to what it is. I have been dealing with it since August. I was diagnosed with underactive thyroid in May of 2022 and am on synthroid 75mg. I have been through 4 rounds of antibiotics ,antibiotic shot, antifungal medication, steroids and a dozen creams and nothing has helped . Dermatologist didn't know what it was either.
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Slow healing of skin/immune problems with under active thyroid 
weird oozing unnamed skin problem 
TSH results and medication problems
Burning Skin
