The skin is more realistic, I follow your instructions better, but the hands are still a problem.
Best setting for realism:
Positive:
(masterpiece, best quality, highres:1.2), (photorealistic:1.2), raw photo, <YOUR PROMPT> (sharp), (film grain:1.3), (morbid light:1.2), (dynamic angle), exposure blend, bokeh, dim light, (hdr:1.4), high contrast, (muted colors, dim colors, soothing tones:1.3), low saturation, morbid
Negative:
cartoon, painting, illustration, (grayscale:1.4), normal quality:1.8, 3D rendering, ugly, fat, frame
CFG: 3
Steps: 15/20
Clip skip: 2
Sampler: DPM++ 2M SDE Karras