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Having diabetes. Found large blisters on claves, bursting, leaking clear pus and drying. What could this be?

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General & Family Physician
Practicing since : 2011
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Hi, Dr. XXXXXXX Thanks for taking the time to maybe help me. I am trying to find help for my niece. She is 50 years old, has diabetes and is in a nursing home cause of her legs. They are forming large blisters on the calves, bursting, leaking clear pus, drying and hardening and turning black. It is spreading around her legs, now, on both. Doctors here in Lake XXXXXXX do not know what it is and will not get her a specialist. Do you have any suggestions?
Posted Fri, 19 Jul 2013 in General Health
Answered by Dr. Guru 43 minutes later

I am sorry for your niece's ill health.

A few possible causes of your niece's presentation are venous insufficiency, immobility from long time, diabetes, peripheral arterial disease, vasculitis (which is an autoimmune condition), etc. Based on your description, venous insufficiency seems likely to me.

As she has shaking spells, the possibility of secondary infection spreading from her ulcers into the bloodstream needs to be excluded.

Though a physical examination is essential to narrow down / confirm the possibilities, can you provide more information about her:

1. Did you notice any enlargement of the peripheral veins of legs before ulcer formation?
2. Can you upload a photograph of the affected leg? If yes, you can mail the picture to YYYY@YYYY with subject line as "Attn. Dr. Vasanth". Alternatively you may upload a picture using the site's uploader available on this page.

At the same time venous ulcers occurring in the back ground of diabetes or due to venous insufficiency are little difficult to treat. Treatment of venous ulcers, if confirmed is usually done under the guidance of a General Surgeon. If she was my patient I would have ordered investigations like CBC (Complete blood picture), ESR (Erythrocyte sedimentation rate, CRP (C reactive protein), BMP (Basic metabolic panel) and Doppler ultrasound of legs.

If she hasn't been seen by a general surgeon, you can request her treating doctor to refer her to the surgeon. The surgeon can examine her leg and perhaps order the same set of investigations and start appropriate treatment accordingly.

Hope this helps! Let me know if you need clarifications.

Wish her a speedy recovery...

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