Dear Skin Doctor

One year ago here in Pakistan not recover this skin problem.

Patient is very poor man having 5 childs.

Please recommend medicine and advise.

Dear Patient

I wish you had sent me more information like if the skin condition is itchy or painful, if it affects other parts of his body and whether other members of his family have it.

However, from the picture it looks like it might be a type of leg eczema.

Leg eczema is a collection of skin diseases that affect the legs and is characterized by itchiness and dryness of the skin.

From the picture, we can see that this skin condition is itchy because of the linear marks (lines) since they are suggestive of excoriations (scratch marks).

The skin over the ankle is also thickened which is suggestive of the lichenification that develops as a result of scratching for a long time.

 

Foot Eczema Causes

Conditions that can cause leg eczema include the following:

1.Allergic contact dermatitis which can be caused by nickel and other substances

2. Irritant contact dermatitis which can be caused by wearing rubber shoes that have been made using a rubber accelerator

3. Stasis dermatitis which is caused by having varicose veins in the legs

 

Foot Eczema Diagnosis

To find out the cause of this condition I suggest the following:

1. Finding out if the symptoms are related to wearing a certain type of shoe which could suggest irritant contact dermatitis as the cause.

2. Examining the whole leg for other symptoms of stasis dermatitis like swelling and enlarged veins.

3. Doing a patch test to determine if it is caused by allergic contact dermatitis. This is done by placing small amounts of the suspected substance on the patient’s back for 48 hours to see if they will develop an allergic reaction.

4. Doing a KOH skin preparation test. In this test, the skin is gently scraped with a blade and the scrapings mixed with potassium hydroxide (KOH) in the lab to look for evidence of fungal infection.

5. Doing skin scrapings for mites. In this test the skin between the toes is examined closely to look for burrows for the mites that cause scabies. This skin should also be gently scraped and examined under a microscope for the presence of mites and their eggs.

 

Foot Eczema Treatment

The treatment of foot eczema includes the following:

Avoiding irritating substances

If the condition is related to wearing a certain shoe or using a specific skin care product, this should be stopped to see if the symptoms improve.

 

Keeping the skin moisturized

The skin should be moisturized several times during the day using products like Aqueous cream.

 

Applying steroid creams

If there is no evidence of infections by fungal or bacterial infections and no infestations by mites, steroid creams can be applied. Examples include betamethasone valerate or triamcinolone acetonide. 1% Hydrocortisone cream can be bought over the counter without a prescription but it is less potent than the others.

 

Taking antihistamines

Antihistamine tablets like Fexofenadine or Loratadine or Cetirizine can be taken to reduce the itch.

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