Fungus/SBE/Tinea Vesicolor?

[down4fun]

I am a RN who just returned from a cruise if the Western Caribbean. I dove in Grand Cayman. I wore a full 3mm and boots. So the only exposed part of my body was my hands, as gloves are not allowed. Within a couple of hours of surfacing I noticed a few small red blisters on my right hand. Very similar to tinea pedis. The pattern seems to match the handle of my dive gear bag. It has a slight tingling sensation, slightly itchy and seems to recede and exacerbate at will. It has been 4 days since the dive and I am know at home. I did a search here and the names and descriptions I put in my titile seem to match what I am experiencing.

I am most interested in what I can do for it at home, as I return to work tomorrow and finding time to see my PCP after vacation will be difficult. I did read in a post from TSandM(? sorry if I got that wrong) about Selsun Blue working topically. Are there any other suggestions and how long is reasonable to wait before I have pursue other Rx treatments. I do have some hx of allergies...Bees (went through de-altertization(sp) shots), fire ants, fire coral (all though less reactive than fire ants).

Thank you all for your help with this.
Kim

 

[fisherdvm]

I do not believe that it is fungus. It is likely irritant (abrasion or chemical), or toxic (sea creatures). I would simply go simple with either petrolateum under a bandage, or at the most over the counter hydrocortisone 1% OINTMENT. If that doesn't improve your symptoms in 24 hours, then seek a prescription topical from your doctor to control the itching.

Selenium works poorly for fungus, but we do use it to help control the spread of scalp fungus in a family, but not as a therapeutic agent. If you want an effective over the counter product, miconizole or clotrimizole cream is widely available as both an athlete foot product or a vaginal product (a little gentler). But again, I do not believe that it is tinea (fungus), unless you've pet some local cats (a high carrier rate of zoonotic fungus), or actually have athlete foot yourself.

Tinea versicolor affects the neck, cheek, chest, upper arm, and groin - where there is sufficient oil to nourish the yeast. I've never seen it on the hand.

What the heck is SBE, subacute bacterial endocarditis?? Can't stand these abbreviations.

 

[down4fun]

Fisherdvm,

Thank you for your response. Although I did not say it was a fungus. I stated that my symptoms seem to match those I read about with the dx of Fungus/Tinea Vesicolor...or SBE (see link below).
Doc Vikingo's Cleaning Smelly Wetsuits

The itching is not really enough to warrant hydrocortizone. It really isn't all that bothersome, except when i close my hand in a grasping action that seems to create a tingling sensation where the blisters are. I guess, I am really just curious as to what I got into this time so I can decide when I need to pursue other options.

 

[fisherdvm]

Hydrocortisone is pretty mild, rarely stimulates secondary bacterial infection, and rarely causes any problems. But simple minded as I am, petrolateum is probably the best treatment for abrasions; and not neosporin/bacitracin/polymyxin, as the incidence of allergic reaction is getting much higher than I would like to see.

 

[The Chairman]

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[CameronMartz]

Just a hooves in Central Park argument, but it is sea itch season in Cayman. Warnings to cover all exposed flesh with sunscreen, oily cream, or even a sea itch specific topical were posted everywhere at Ocean Frontiers when we were there two weeks ago.

As the warnings clearly described, the nematocysts will fire when stimulated mechanically or with hot, freshwater. The fact that the red bumps line up with where you grab your dive bag, the fact that the bumps as you describe seem 100% consistent with sea itch, and the fact that you were in Cayman suggest sea itch as the easy answer.

Some info from an article regarding a previous peak of sea itch can be found at http://www.caymannetnews.com/2006/02/1039/strikes.shtml:

"The common symptoms include intensely itchy skin eruptions with small blisters and elevated areas of skin...

The symptoms will appear very soon (24 hours or less) after exposure to the organism and will persist for several days. Some cases have been reported which have a three- or four-day delay in onset and a prolonged course lasting several weeks. Symptoms may include fever, chills, headaches, nausea and vomiting."

Cameron

 

[down4fun]

Thanks Cameron,

I am sure that is what I have. It has been a week since the dive with little to no change in the outbreak (for lack of a better term). Being a nurse I was my hands many, many times a day which seems to reactivate it to some degree. It also makes the use of anything topical not very effective as I wash it off almost immediately. For the most part it is tolerable and I am prone to just let it ride its course. Although my non-diving Director of Nursing needed some reassurance that I wasn't going to start sprouting some tentacles from my palm like some form of alien-jellyfish.