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I think I may have scaly skin that's caused by something called two foot/one hand syndrome. What do I do?


In the November 2002 issue you mentioned that scaly skin can be caused by something called two foot/one hand syndrome. I believe that I have just that. (It’s awful.) What do I do?


Two foot/one hand disease is caused by a dermatophyte fungus. In this condition, both feet and one palm have a scaly, dry appearance and test positive for fungus when scrapings of the flaky skin are tested. Often there is fungus in the toenails and fingernails of the affected hand. Treating with an antifungal medication (oral works best but topical helps too) clears the skin of the palms and soles. There is a fairly high recurrence rate of this fungal condition, so long-term preventative treatment with a topical antifungal cream is helpful. There are many other common skin conditions that mimic this fungal skin problem. Eczema can cause scaling and flaking of the palms and soles and is not related to fungus. Psoriasis can also cause similar symptoms of scaling, peeling, and thickening of the palms and soles. It is important to get the proper diagnosis of the problem so that appropriate treatment is used.Phoebe Rich, M.D.

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