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Irritation in legs from boots. NEOSPORIN, ARNICA GEL.

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I am 66 years old patientold. This started out about 6 months ago as what appeared to be an irritation from the inside of my cowboy boot on the inside of my right leg just above the ankle. I have tried Neosporin, Arnica Gel, and Arnica Cream. Nothing seems to do anything other than releive the dryness for a while. There is not really any pain at all associated with it now like there was at the begining when it first started. How ever, it does look worse now than it ever has even though the pain is almost nothing. In fact the area on my right leg is geting numb. When it first started it was like a burning itching feeling. About 2 months ago it began to do the same thing on my left leg. Inside just above the ankle. When it first started it was like just the fact that my sock touching the skin there was irritating to it. As you can see my right leg is much worse than the left. I didn't notice my feet and ankles started swelling until just about a week or 10 days ago. The swelling in my feet and ankles seems to come and go and varies from one time to the next. I would like to know if anyone can tell me what is gong on here?

Category: Dermatologist

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Category: Sexually Transmitted Diseases(STD)Specialist
 22 Doctors Online

Hi,
Thanks for posting your query at DoctorSpring.com

I have seen the attached images. I can think of two possibilities in your case. Either it could be contact dermatitis (due to socks or shoes) or eczematoid purpura of dukas and kapetenakis.
Now in both the cases, I initially advise the following treatment
Apply a good emollient like cetaphil restoraderm twice daily
If the lesions are just dry itchy and red, use a potent steroid cream like clobetasol. If lesions are wet or oozing, use clobetasol mixed with fusidic acid twice in a day.
Take an oral antiallergic like claritin once to twice in a day.
Wear old cotton socks washed in hypoallergenic detergent.
The lesions should respond in five days to a week.
Also its my sincere advise, that above treatment should be started only after you have consulted your dermatologist too.
Lastly please accept my apologies for delayed response. However let me assure you, your condition is treatable. The swelling, pain. numbness in lesion could be due to chronic itching and inflammation.
Should there be any doubt, please write back.
Regards


Patient replied :

It appears to me that you may not have read my description of what is going on with my legs. If you didn't, please read and reply again. It is not itchy and not oosing any where. It is however numb to a degree. Any idea why my feet and ankles are swollen? Is there a dermatologist in your list of specialists?


Hi,
I have gone through your query again. Let me summarise it. You have red scaly patches over your limbs which were initially painful, had burning and itching sensation. Now slight nubness
and pain is there along with swelling that comes and goes. Also I have analysed your pics again where I can see your veins prominently.
I would still keep the two differentials mentioned previously along with another differetial of Gravitational eczema.Gravitational eczema is due to varicose veins or venous insufficiency where the blood fails to return from lower limb to heart resulting in pooling of blood which presents with swelling in lower limbs, eczema due to irritation caused by pooled blood, pain in affected limb, itching sensation etc. The eczematous area due to frequent scratching can become oozy or get infected causing erosions.
In gravitational eczema, varicosity of veins and deep vein thrombosis should be ruled out. This can be done by clinical examination of the lower limbs and getting a doppler done to assess blood flow in affected areas. In gravitational eczema, foot should be kept at slightly raised position to help the blood flow towards heart, this would reduce swelling to some extent. If varicosity is there,wearing compression stockings would help. Deep vein thrombosis as I said should be ruled out and if diagnosed should be managed on urgent basis as its a serious condition.
The initial treatment remains same as I had mentioned in my previous post. A doctor's visit is advised to rule out gravitational eczema.
Hope this helped.
Regards


Patient replied :

What are the potential causes of my swollen ankles and feet? It comes and goes.


It is mostly due tto gravitational eczema.


Dr. Kalpana Pathak
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
M.D. from Pt. B D Sharma Postgraduate Institute of Medical Sciences, Rohtak in 2011 with Haryana State Dental & Medical Council
M.B.B.S from MLN medical college allahabad in 2006 with Uttar Pradesh Medical Council
Dr. Kalpana Pathak and 4 other Medical Specialists are ready to help you

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