Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Dry skin, Dyshidrotic eczema, Pain, Paraesthesia, Sensitive skin
Clinical narrative: On 4/25/2022, I received my second Pfizer booster for COVID-19. Later the same month, I noticed that on the medial side of my left index finger, there were some very sensitive spots on the skin. At first it was subtle, but then over the summer months of that year, it persisted. It also got drier. In early August 2022, I noticed a similar condition on the right thumb at around between 1 and 3 o'clock around the tip. In September 2022, I went on a backpacking trip in a more elevated, much drier area. During the trip, the dry areas on my left index finger and right thumb cracked open. It was very painful, and I ended up putting triple antibiotic ointment on the affected areas and bandaging them. The condition persisted for about a week, and when I got home, I put more triple antibiotic ointment on the affected areas. I then applied liquid bandage to them, and I did this for a while until the cracks healed. In October 2022, the affected areas were just dry, though they weren't cracked. However, I was puzzled about it and thought that it looked worse than regular dry skin. In probably September 2022, I saw my PCP. When I showed him my fingers, he said that it just looked like dry skin. However, if the situation worsened, he wanted me to let him know, so he could refer me to a dermatologist. On 11/3/2022, I got my third Pfizer booster (GH9697) for COVID-19. In the middle of November 2022, the affected areas on my left index finger and right thumb cracked open. At that point, I applied triple antibiotic ointment and liquid bandage. I also basically taped my fingers up for extra protection. I then noticed that the same sort of dry, sensitive areas began appearing on my right index finger and my left thumb. On the left index finger and right thumb, the already extant areas began to spread on those fingers. They also became drier and would quickly crack afterwards. It kind of seemed to go in cycles. The drying and cracking would come on very strongly and aggressively for a day or two, during which time I would apply the antibiotic ointment, liquid bandage, and tape. I also began wearing cotton gloves to keep the tape in place. Through November and December 2022, the wounds would almost heal over a period of two to three weeks, only to become dry again and crack. This condition persists to the present day.  On 12/21/2022, I saw a dermatologist. The dermatologist basically just thought that I had dry skin and that I should drink more water. He also prescribed steroid cream to apply to the wounds. He also instructed me to get better-quality OTC hand cream, such as Cetaphil. Since December 2022, I have been using the steroid cream as needed. The steroid cream doesn't help enough, because the dryness and cracking phases still continue, and the cream doesn't stop them. About every day, I have been applying the Cetaphil cream 10-20 times. I use my hands every day, and I reapply the Cetaphil cream every time after I wash my hands. The Cetaphil cream basically just relieves the dryness temporarily. I wear cotton finger cots on both of my thumbs and index fingers daily to help the cream absorb better into the skin. I also wear them to bed. I saw my PCP this morning. Shortly before the affected areas crack, I can feel a tingling sensation at the fingertips; the fingertips also become sensitive when they touch metal objects. I even once sliced one of my fingers when I flipped a light switch too quickly. I play guitar, but oddly enough, the guitar playing hasn't affected my fingers, and the skin condition has not affected the quality of my guitar playing. When I mentioned to him the fact that the skin issue and its exacerbation didn't take place until after I had had COVID-19 boosters, he speculated that perhaps the boosters had affected my immune system to the extent that I had developed new sensitivities to things that dry out my skin. The doctor labeled my condition dyshidrotic eczema. I had speculated before the visit that perhaps my statin had somehow caused the condition, and I was planning to request a reduced dose of the statin. However, the doctor didn't think that was the case, as I had been on the statin for much longer than I had had the skin condition. After he speculated about the possibility of the COVID-19 boosters causing the condition, he said if the boosters were the cause, then the condition should eventually resolve on its own. He then advised me to continue using the steroid cream, Cetaphil cream, and finger cots. Since January 2023, I have also had similar dry, cracked areas on the balls of both feet. After the cracks heal, brownish dry patches grow over the cracks. I have been very vigilant about keeping Cetaphil cream on the balls of my feet. This isn't too difficult, since I wear socks and shoes all day long.