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How has scleroderma affected the palm of your hand?


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#1 ez62

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Posted 14 October 2008 - 06:10 AM

I have not been diagnosed with scleroderma, but some very dramatic changes have ocurred to the palm area of my hand and I am curious if any of you have anything similar. My left hand is much more seriously affected. All of the tendons (I guess thats what they are) in the palm side hand have become very pronounced. The area below my fingers where the fingers meets the hand looks swollen with no lines. My pinky sticks out to the side really far which it doesn't do on the other hand.There are alot of little lines in the area where my thumb comes into the hand like it is being pulled tight.The middle of both palms has developed a very strange consistancy, like when I get it wet it feels like caqrdboard or something, kinda hard to describe but strange. Obviously with all these changes, my hand feels very weird, I can still do what I need to do but have to work at it more. Also does change colors a bit, sometimes white sometimes mottled reddish doesn't seem to be associated with the cold though. Definitely requires more effort to hold my hand out straight really feel resistance.
I'm a little freaked because when I was looking up the palm thing online, as it has gotten so much worse, Im seeing a palm issue- cancer connection. I was just wondering if people with sclero have issues with their palms as well- thanks for your help, btw I also have face/skin changes and tummy troubles
Eileen

#2 Piper

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Posted 14 October 2008 - 10:45 AM

Hi Eileen, I'll be interested to know if anyone else has had these changes to their palms because I have had hardening of my palms as well. They are also drawing in. Didn't know about the connection to cancer, yikes! I thought at the beginning that mine might be connected to Duputryen's as my father had this. My Dr. says no because my whole palm is involved and not just near the fingers. Then there's the fact that I have raynauds and a scleroderma like esophagus. I don't have a diagnosis though.

Hugs, Piper

#3 beedee

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Posted 14 October 2008 - 12:16 PM

Hi ez62,
I have morphea, and it is in the palm of my left hand among other places. It has left parts of my palm very very hard. Not much discoloration, sometimes some tiny purplish spots, but I think that might be from the steroid injections they were doing in my palm. But in the upper palm, there are a few very hard bumps, I know what you mean by the tendons (or whatever) seem more pronounced. It is in my ring finger as well, and the skin looks like it has more lines, and is kind of tight. The movement of my finger has been restricted as well. I do not have raynauds, this is just what the morphea has done.

#4 smac0719

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Posted 14 October 2008 - 12:48 PM

Ez62,

I can not relate to the palm problems, but also have scleroderma with gastric and skin issues. My face used to feel like I had a facelift without the surgery. Pimples didn't even come up to the surface, but I could feel them underneath the skin. That changed with the increase of my methotrexate dosage (started on 8mg and am now on 20mg). I also have skin tightening and and I had itching but I don't itch anymore. I think that is due to the metho and plaquenil.

I hope there are some folks here who can give you some feedback on your palms. Have you seen a Dr yet for them?
I may have Scleroderma, but Scleroderma doesn't have me!

#5 anonym4444

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Posted 14 October 2008 - 11:22 PM

Hi,

ez62, I think many things you describe resemble my hands and palms.

It started in June 2007 and started with the skin sometimes showing strange red/whitish color (like marmor)...(no Raynauds even up to now).

It went on with the skin feeling stretchy more leathery on the palm are below the thumbs (when I typed on a warm Laptop the skin turned very reddish and was very smooth). Same happened to the index finger skin where the Laptop had to operate the trackpad.

In July of 2007 the areas below the fingers started to swell a bit and there appeared new wrinkles along the finger in the direction of the fingers and the skin began to work agains stretching the fingers (like you describe....having to put more effort in stretching)....

In August I could clearly see the stretched skin showing wrinkles in longitudional direction all the way to where the hand is attached to the forearm....and the palm yes pulle inwards and the skin let me see more and more of the veins especially when in water.

In September the fingers began to swell (marriage band)....and more and more of the normal fingerprint like pattern on the first and second part of the fingers disappeared. And if you looked along the fingers it was a bit shinny. At night the skin burned and tingeled sometimes (I do not know if that is what people here call pins and needles and it probably was not so bad...but it was strange....either I got used to it or it went away after 2 month or so ...I still feel slight tingling at night, but it is only if I tune into it)

In January I had something that I would call a mini necrotic behaviour on the right index finger.

From then on I had sometimes a few splitter haemorraghes under the nails.

The nails became more curved in longitudional direction and they became shorter.

In April of this year the swelling become more and it actually hurt on some fingers (especially the indexes and more affected on the right hand side). Also the skin on the fingertips felt like if it had superglue on them (especially indexes and thumbs).

The skin of the whole palm feels more leathery and dry and you can even produce some strange sound if the finger tips move across it with force (with no force it is too smoot and dry to produce noise).

Now in about July of this year the swelling of the fingers became more permanent and also became harder and it felt like I have a second thin layer of dry skin that hindered stretching and if stretched with force also refused a bit to let me bend again (and it hurt to bend just like the skin was worn out).

In August I recognized that the skin of the fingertips (again especially right index and a bit less the left index became very dry and hard and did not even let moisturizing solution let go through at night). I also recognized that at 2 areas where I had a wound in April the skin became thicker and harder and as it was in an area, where you need to bend (inside) I recognized that the skin there was refusing to bend easily...also recognized that you can peel this excess skin off in the bathtub and then it was OK...but came back latest a week later....still have those areas.

Now in August/September the tips of the indexes (I had long time recognized, that I had trouble operating the mousepad as my fingerprints were almost none existent) became harder and smoother and I tried to peel off in the bath tub....peeled off it feels like normal (not that strange superglue feeling), but comes back and it becomes harder immediately. The skin of the whole fingers (especially indes and second) feels strangely leathery (like the palms) and harder and less felxible (on the inside only) and feels way to smooth and way to dry and without normal felxible behaviour (more like rubber) and hence I have trouble separating cards, turning pages.

Also if I put pressure on the palms I have a strange mark...(like carrying a plastic bag or another sharp object)....in that case the blood coming back takes way longer (also happens on the fingertip of the right index with the trackpad) and the indentation stays for a while...same with sharp objects etc. (check mannys descriptions)....also holding the steering wheel which I have wrapped with textile will leave some texture copy on my skin which is visible for quite some time...

In general it seems that the tips of the affected fingers behave more like rubber or like wax. Smoth, less flexible stangely dry and more slippery....

I guess whatever you describe (and what manny describes) is very close to each other...all 3 have no diagnosis....interesting....

But I would not attribute it to cancer....for sure not....this is some kind of skin change and involvement....nothing else.

BTW: in my case Sicca is definitely also there. (eye and mouth)...not severe but dry....no Raynaud, no ANA yet. Slight blood circulation problems sometimes with emotions of cold (but not hurting, no color change...just colder than normal). And certainly puffy fingers for sure. Bloodwork completely normal except for my Yersinia infection that I am currently treating and which in case they were right has been going on for at least 1 year or possibly the whole 1.5 years....was found first time after 0.5 years...

K.

#6 Sam

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Posted 15 October 2008 - 03:03 AM

Yes I think sclero can affect the hands in the palm too. You cna have carpal tunnel, you can have problems with your tendons. I know a few people with having problems with both. I dont know much about it but thought I would post to say yes I think it can be caused by sclero. Take care and let us know what the doctor says. Sam
Sam

#7 Kim T

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Posted 15 October 2008 - 08:03 PM

This is one for your doctor. I have a co-worker with curled fingers which made me think of sclero. He said he has a condition where the tendons tighten and pull in the fingers. Surgery has helped but I quess it's stayed the same for years now. He's in his 50's. I don't remember what he said it was called but not anything as serious as scler or cancer.

#8 manny

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Posted 16 October 2008 - 06:16 AM

Hi ev62.

I'm having very similar palmar issues.I agree with anonym444 that we share similar characteristics pointing towards a connective tissue disorder of some sort.However,I cannot definitely say its scleroderma related.

The skin beneath where my fingers start on the palmar aspect of both hands appear inflamed and are starting to feel leathery now.It kind of looks exactly like a picture of palmar fasciitis and duprytenes contracture if you do a google search.
If I bend my hand inwards bringing the fingers toward the palm I can see there's excess skin hitting beneath the fingers.

Also,my entire hands hurt all the time,especially the fingers and the palms on both sides.It happens more often when I wake up in the mornings.I have a hard time getting out of bed because of all the pain.I get the same painful burning feeling on my toes.I gets worse when I apply pressure to my palms and soles.If I apply pressure like holding something, a steering wheel, cell phone or even typing for prolonged periods my hand hurts all over.It's exactly like anonym444 described.It stays red like as if the blood is not moving and leaves an imprint of the object I was holding.The same happens on my soles of my feet.If I'm walking my soles hurt.I have a hard time wearing shoes becuase they feel tight around my toes and hurt.I wear sandals now,but am afraid to put on shoes because of the winter coming soon.

Also, at night my hands appear waxy and shiny and then it goes away and is completely dry.It does not sweat,but appears like it is.I'm thinking it could be related to some sort of autonomic nervous system dysfunction.Along with the other symptoms I feel like my immune system is suppressed.I get weak and tired all the time and just completely out of energy througout the day.

In the beginning I also suspected cancer of some sort, but highly doubt it now.The symptoms appeared so similar to that of palmar-plantar fasciits,a paraneoplastic syndrome highly suggestive of cancer.It may in fact be scleroderma related or mixed connective tissue disorder,definirely not cancer or duprytenes contracture related.But then again it be part of some immune related process of another rheumatic syndrome.

I thought this all was related to my pulmonary issues.I was daiagnosed with severe interstitial lung disease a year ago and only seems to be progressing.I've seen another pulmonolgist like two days ago and he suspected sarcoidosis.He wrote me a script to check me ACE enzyme levels,but have yet to do it.He said if its high its definitely sarcoidosis,but if its not then he referred me to see a rheumatologist.He said the pulmonary issues seemed to be secondary, part of another rheumatic syndrome causing the pulmonary issues.

Also,when he did a physical exam he palpated the abdomen and found that my spleen eas enlarged.That probably explains why I was getting alot of left upper quadrant pain for the last two years.He said that my blood tests revealed high red blood cells and low mcv possibly related to spenic dysfunction.That could also explain the pain in my hands and feet.He suggeste I get an abdominal ultrasound.The worse case scenario being to remove the spleen.The speen is often inflamed in immune disorders.It could be a variety of disorders.

Also,My naifolds beneath the nails on my fingers seem to be inflamed.They look completely black like as if there is dead skin.I think that it might be the nailfold capillaries.I don't know if it is and I asked here several times and no one bothered to respond.If it is its highly suggestive of a connective tissue disorder.

My only advice for you and anonmy444 is to monitor this closely.We may in fact l have the same disorder.It might be helpful if you check to see we share other similar symptoms like the ones I described in this post and my previous ones.So my question is posed to both you,anonymm444 and others. Check your blood tests and see if your red blood cells and mcv are normal? Check for the ACE enzyme.Inspect your spleen.Have someone push it really hard while you push it out like as if you're pushing your abdome aginst the resistance of his hand.Ask him if he feels something while you push it out.Also,inspect your nailfolds.Do they seem inflamed like I decsribed?Do you feel tired and achy around the hands and feet,especially in the morning.Also do my other symptoms appear similar? Thank You.

#9 anonym4444

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Posted 16 October 2008 - 09:29 AM

Hi manny and ez62...

for sure there is one more similarity...you mention the skin between the fingers...yes, that was the first I noticed, that it is getting strangely smooth in between and as the finger rubbed more at each other (as the skin or fingers were swollen) this more smooth skin felt strange (this was about 0.5 year into the trouble)...by now (1.5 year) it feels also more leathery (less smooth now)...but not just there...also the complete palm and even the first and second part of the insides of the indexes and the same (however less so) on digit 2....digit 3 and 4 are almost unaffected. The tips behave different...they fell mostly rubbery and yet as they lack sweat and fluid you have to press hard to get resistance between the fingers. The index ones however turn even more hard (right hand index tip is more like the excess skin on my soles of the feet - I do not know how you call such hard excess skin that builds up with excessive stress that also normal people have...but not on their fingertips...no fluid has a chance to get through or to soften it). So that by now I have almost a less flexible cap on my right index that hurts when operating the mousetrack sidewards.

And as I said, each wound ends up not softening up but around the area there is extra skin buildup and if removed (as you can peel it off as it is harder than the rest) comes back again soon.

In my case only the Sicca (eye on left side become more severe right now, scratches like sandpaper the whole day, despite the fact that through the scratching there is actually fluid) and the Spine problems (Spondylosis) represents the almost all of my current general problems....sleep is more needed...but this is mostly due to sleeping sometimes almost not at all.....call 911 it says here if you have a gloomy feeling and think about suicide and can not sleep...hey, then I would have to call them every night and even sometimes on the days too...(not to mention, it is 110 here...:-) and this for the last 12 month...with some breaks in between when I was able to convince myself for a few days that it can not be, what it most likely is, if you can sum up 1 and 1....and to make things worse, as nobody really finds a hard diagnosis and does not even look closely at the obvious I feel even more depressed to watch things deteriorate without anybody doing anything against it before there is no more serious damage. That is what drives me nuts. If I have such a disease at least there would be some hope to slow it or stop it for good or a while....e.g. untill my kids are out of the worst. But as nobody treats anything.....it continues on its path. Until something severe happens so that a doctor finally sees a need as well to do something....I guess that is what makes this disease so horrible on top of all the various things it attacks and pain it causes. That you almost have to run and convince the doctors what you have as they do not want to see the obvious.

I have sworn myself that I will try to insist on a skin biopsy or capilary mikroscopy....(BTW: in my case the area below the nails is OK...possible some nail skin thikening but could not tell for sure). However my moons of the nails are strangely blueish (were white) and also the rest of the nailbed looks more blueish especially toward the moons. And: if I stretch my fingers all the way, then on index fingers the nailbed becomes white in the upper half. On the other fingers this is less visible.

BTW between the fingers I sometimes get some itching and then some small pimples (is that the english word) appear which itch even more and if I scratch they open up, spill some clear fluid and then it is fine and after a while the whole thing dries and goes away with some scaling of skin around the area of the original pimple....they apear in bunches especially between the fingers close to the knuckle area....also this gets worse (more often, more of them, on ever more fingers)....this was the only thing the dermatologist notices herself...and was interested in (I am not sure, if this is connected, independent or a secondary problem due to drier skin)....but is seemed to attract her and possible was the source of her writing "psoriasislike skin problems"....but this does not even look like Psoriasis scaling and also my nails are just curved and not like Psoriasis nails.....

But there is a (scientific) report here, that more curved nails are highly specific for.....you got 3 guesses....

K.

K.



K.

#10 anonym4444

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Posted 16 October 2008 - 10:08 AM

BTW: Dupuytriens was also a suggestion one doctor gave me a year ago...but hey, Dupuytriens does not change the skin or creat Sicca or like in one case mentioned here cause interstitial lung disease (hey, does that not ring a bell?? Or when is the bell loud enough to be heard...I mean I can understand the doctors partially in my case...but if ANAs are slightly high or I have already lung disease then there is not too much left to make the connection - or is there?)

Thats what really worries me...if such cases can not even find a diagnosis....hey, who can?

K.