Hello
Thanks for posting your query at DoctorSpring.com
I can understand your concern.
She seems to be having allergic contact dermatitis.
It could be due to application of some oil or creams in case she does.
I would also like to know if she has any other ailments. Whether there is any history of varicose veins?
Also if you could also let me know the names of the creams that she has already applied.
I will be able to opine in a better manner once I get this information.
Thanks
Patient replied :
Hi doc,
Thank you for your answer. Now, let me tell you more about her other ailments that might be in a relation with the current skin condition.
Her main medical problem is carotid artery stenosis and retinal artery occlusion. For this reason she’s been taking anticoagulan?s (Syntrom) and vasodilators (Pentoxiphylline) for many years.
Since the last summer she had swelling around the ankles (along with the rash), Doppler ultrasound exam of legs was done. The diagnosis was: Varicose veins of the lower limbs without ulcer and inflammation; Thrombosis of the right posterior tibial artery; Varicose eczema of the left calf. The treatment included Endotelon tabl and topical corticosteroids (Fucicort cream).
All the blood tests were normal.
Hello
Thanks for your reply.
She has varicose eczema which keeps flaring up. Its due to the varicose veins hence it never goes off completely since the pathology causing it is still persistent.
I would recommend application of elidel cream twice a day for 3 weeks. It will not resolve completely with that but it should improve. Elidel is a steroid sparing agent and will need a prescription. You will need to follow up with her dermatologist so that her condition can be evaluated and further need for the cream can be decided.
Take care
Patient replied :
I'm not sure that the diagnosis varicose ecsema is the right one. The doctors simply tried everything they could without any result. Btw I'm a doc too but pediatrician and dermatology is not clear to me, not at all. But I have to find a kind of a treatment cz she needs some sleep. Elidel cream is an option but I'm concerned about its side effects. Yesterday I bought an emolient and hope she'll get dome relief. Varicose veins cannot be cured completely, specially at her age.
Thank you for your advice. Have a good day.
Hello
Thanks for your reply.
In the light of varicose veins a dermatitis is usually due to the venous stasis. That's what she seems to be having. Eczema is due to inflammation of the skin so just an emollient won't help resolve her condition completely.
Elidel cream wouldn't have side effects with short term use. As you are well aware we can even use it safely in children.
Since its a steroid sparing effect it has no side effects that steroid creams could cause.
Is there any oil that she might be using to massage her legs?
Thanks
Patient replied :
Thank you for your last reply and support. Now I'm almost convinced to start treatment with Elidel. I'll let you know if there is some improvement of her skin condition. As I understood after making a research, there is no problem to use both emollient and Elidel. Isn't it?
Is it ok to buy a baby oil for massage?
Thank you again for your consultation.
Hello
Thanks for your reply.
Emollient and elidel cream can be used together but at seperate times otherwise emollient will dilute the effect of elidel.
I wouldn't recommend massage at all as friction will increase the dermatitis.
Thanks