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Leg Turning Yellow And Skin Peeling. Feeling Fatigued. Should I Be Worried?

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Posted on Wed, 1 Aug 2012
Question: Hello, my name is XXXXXXX and am asking feedback on my fathers legs, which turn yellow and is peel-able, and they drip water, he lives in the third world country and needed to ask here for more information if this is a disease. Almost a week ago he got sun he claims on his leg and felt very fatigues and went to the hospital and they told him him he was in crucial condition and the doctors said they almost amputated his leg, He has told me that his leg is not becoming a black color, "Is this something we should be worried about"? He weighs around 370 pounds and Doctors in Europe told him that he has to loose weight.

*If explainable about this condition and if this is disease please explain.
*Cure
doctor
Answered by Dr. Dr. Prasad J (3 hours later)
Hi XXXXXXX

Thanks for the query.

I was able to view the picture. It seems like your father is suffering from a condition known as "cellulitis". In simple terms he has some kind of infection progressing under the skin (subcutaneous). The infection results in inflammatory process that causes localized oedema (fluid accumulation), swelling, pain, redness, skin peeling and so on.

It is a concerning issue and the usual cause is mixed bacterial infections.

The condition poses serious problems and treatment is centred on finding the pathogenic bacteria, starting a sensitive antibiotic preferably intravenous and preventing progress of symptoms.
Since the condition is commonly associated with diabetes, his blood sugars need to be checked and if abnormal that needs to be treated immediately.

If the condition is rapidly progressing, he might need an emergency debridement (surgical) procedure. Amputation would be the last option if the progress is very rapid and other conservative treatments are not yielding good response.

This problem concerns me. And hospitalization may be beneficial.

Hope this answers your query. I will be available to answer follow up queries if any.

I wish your father a safe and speedy recovery.

Best Regards
Dr. Prasad

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (10 minutes later)
Hello

Dr. XXXXXXX

I Thank You for your information and the cause of the symptom "Cellulitis" of which he is suffering, This picture was taken a year ago and this is very serious as you say at this period of time. I have mistaken my word, His leg is turning black he told me a little over week ago, I had asked him if it was gangrene, he was not sure how to answer me, which very worries me. I am not sure how his situation is now.
doctor
Answered by Dr. Dr. Prasad J (1 hour later)
Dear XXXXXXX

I thought the picture was the current one!!

Anyway, skin colour changing to black is also a concerning problem. As you mentioned in your previous report, if the skin is leaking fluid and is peeling it is suggestive of wet gangrene. The cause here is again an infection. Identifying the infective organism and treating it is important. Amputation will be certainly needed if the parts are completely not viable. The procedure may be combined with wound debridement if parts are partly viable.

As in the first case, a recent picture revealing the current limb status would have been more informative.

And since you are also staying away from your dad, please ask him some details which can confirm whether or not he has gangrene.

1. Which part of the limb has darkened?
2. Ask him if he is able to feel the sensations over the affected areas.
3. If it is cold to touch?
4. Are the nails brittle and breaking?
5. Have the doctor's documented any pulse in the affected limb?
6. Whether or not a Doppler or angiogram done on the affected limb? - If yes, the results of the test?
7. Is there any wound along with leaking discharge?

The above information can help us known the status of limb and the next steps of treatment.

Hope this helps.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (23 hours later)
Hello

Its my fault and accident that i did not clarify myself and i apologize. The picture, i sent from before was too see what he was suffering from, he lives in Macedonia and i live in the States of XXXXXXX His leg has the same results as the picture i sent you this time but with more aggressive symptoms. He has told me today.

I Asked him your questions and he said that his right limb is affected, he says that the spot is not cold, nails are not breaking or brittle, has not gone to the doctors to check on his situation, father tells me that there is leaking and that he has wounds on his leg.

I am going to receive a picture tomorrow from him for a report review so this may help find and see if the problem is serious enough for further actions.

This information was very helpful Dr. XXXXXXX and i Thank You for your insistence to help us with this event that we are going through.

I just lost my Grandmother that i lived with for long time and raised me for many years that I've been with which was his mother, and this started before she went to the hospital and talked to my father about her health deteriorating and he fell very ill and his blood pressure went very high up and this happened. Grandmother passed away Monday she was 87. I don't want to see this happen to my father to pass away either so very close to her. This is the reason i asked for professional help from Doctor, I am Thankful to have you concerned and helping us through these hard times.

Appreciation, XXXXXXX
doctor
Answered by Dr. Dr. Prasad J (47 minutes later)
Dear XXXXXXX

I am sorry to know about demise of your loved one. I understand you are having a tough time dealing with it. So I really appreciate your efforts to seek online help despite the suffering.

Reduced blood flow is one of the reasons for a non healing ulcer / wound. And such non-healing would are often progressive resulting in cellulitis if not treated correctly. Gangrene is the end result when there is total loss of blood supply. Perhaps the cellulitis which your father had earlier one year ago could have been the results of reduced vascularity.

Warmth and normal toe nails are positive signs; but I shall wait for the picture to give my final comments about the viability of the limb and what type of treatment would be needed. A picture of the entire limb with close up pictures of the affected area, peripheral toes, wound and discharging areas can provide good clues about what is happening.

In all, I am concerned with what is happening now. Please encourage him to visit a nearby health care centre. Careful examination of the limb, detailed evaluation of peripheral blood circulation, review of blood sugars, intravenous antibiotic and proper dressing of the wound would be needed at the earliest.

Hope this helps. I will be available to guide you through the treatment on this forum.

I wish you and your father good health.

Best Regards
Dr.Prasad

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (43 hours later)
Dr. XXXXXXX

I Thank You for your sympathy for my grandmother, i take that to the highest respect and yes it is hard too deal with loosing a loved one and don't want to deal with another one over again so soon.

Yes the doctors there have told him that he does not have enough blood supply working properly for him. I am certain as you are that it is from low vascularity.

My father this time does not have the wet gangrene this time as i thought, but his leg is very much swollen as iv'e ever seen before which worries me. He claims exactly two weeks ago when he went to the hospital that he could not touch his leg because of very much extreme pain. He told me today that his leg does not hurt as before.

The doctors there have told him that he has "Dermatitis" i have read about this and have researched this:

(Individuals who live in urban areas with low humidity are more prone to develop this type of dermatitis.)

This makes me think of when i lived there in the place he is at and the walls and ceilings were turning black from low humidity. This affected my grandmothers legs also when we were living there in the apartment. Her Situation had become worse and i am assuming this is why.

Today i have a picture of his leg, I apologize for not having the picture yesterday as there was high winds and no Internet Access yesterday.

Respectfulness
XXXXXXX
doctor
Answered by Dr. Dr. Prasad J (2 hours later)
Dear XXXXXXX

Thanks for posting the picture. I must say the picture was indeed informative.

Dermatitis which refers to inflammation of skin is of various types depending on the causative factors such as allergens, irritants, skin dryness, vascularity and many more. The picture you sent is suggestive of "Stasis dermatitis" a condition associated with venous insufficiency (unlike my initial suspicion of arterial blood supply deficit - gangrene.

Low humidity has no significant role in the development of stasis dermatitis. Here the probable causes are blocked veins - thrombotic or embolic; varicose veins, age related reduction in venous valvular competency, a failing heart, etc. A clear cause can be established by a detailed systemic and local examination, Doppler scans and some routine blood test.

Though it is not as XXXXXXX as cellulitis / gangrene and radical measures such as amputation may not be needed immediately, it is definitely concerning. When not treated adequately, the swelling can progress leading to more pain, infection (cellulitis) and compression of arterial supply. When the later happens gangrene is eminent.

My suggestion to you is - talk to his treating doctor and know in detail about the severity of the problem, details of test done and what they think is the probable cause. Discuss with a surgeon whether or not he might need a surgery.

From what I see on the picture, his condition is not as concerning as I initially thought and can be managed with adequate limb elevation (inform your father to keep his limb elevated above the heart level always), regular wet dressing for the weeping lesion, a diuretic (water pill), good antibiotic cover and compression stockings before we opt for surgery. Nevertheless, it needs to be monitored regularly.

Hope this helps. Let me know if you have any other inquiries.

Wishing your father a safe recovery

Best Regards
Dr. Prasad

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (25 hours later)
Dear Dr XXXXXXX

Your are very welcome for the picture and am knowledgeable about your information of this infection and appreciate that your knowledge has has been informative to us.
I did not know which of the infections he had, now ascertainment is final.

This needs to be treated as you suggest with antibiotics,diuretic and stocking. I am worried this does not escalate severely of this matter as this will put a huge burden on us. He is married just almost 8 years now and has given birth to a son 4 years old and a daughter that is not even 7 months old, and this is very hard to understand when a situation like this approaches our way, this is very upsetting as we know, my grandma, his mother passing away is very hard too feel on this situation because she is now another place and having fear of my father disappearing is very very hard too deal and even think about as i focus.
I write this because i know from one situation leads too another situation of the worse is amp is an option as you tell. I have very low slow hopes of this becoming any better.

I see this you write about weeping lesion, and read that itching is common, and have not mentioned to you that my father claims yesterday that he has a sever itching problem on his infected leg.

I will tell him about the (Doppler Test) to be done for him and too ask about how serious they say about the subject of his leg.

Thank You for your safely recovery input for my father, i appreciate every time your gratitude for us and your answers are very beneficial as always.

As my Doctor, Uma Gunnala and have great respect for her, i believe in kind,honest, from the heart doctors and am very fortunate to have.

I see her in over month and when she find out about my grandmothers death as my grandmother was one of her patience, she will have a very hard time understanding because this will hurt her as they were Patient - Doctor for over 5 years.

Thanks again Dr. XXXXXXX

Sincerly,
XXXXXXX

doctor
Answered by Dr. Dr. Prasad J (1 hour later)
Thanks for your feed backs. It was my pleasure discussing with you.

His condition should improve with good limb elevation, diuretic and stocking. Once you get the necessary information from his doctors and the results of Doppler scans, things will be much clearer.

Hope this discussion was helpful. I will be available on XXXXXXX ( WWW.WWWW.WW if you wish to update me in future.
If you have no more follow-ups for now, please close this discussion.

Regards
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Leg Turning Yellow And Skin Peeling. Feeling Fatigued. Should I Be Worried?

Hi XXXXXXX

Thanks for the query.

I was able to view the picture. It seems like your father is suffering from a condition known as "cellulitis". In simple terms he has some kind of infection progressing under the skin (subcutaneous). The infection results in inflammatory process that causes localized oedema (fluid accumulation), swelling, pain, redness, skin peeling and so on.

It is a concerning issue and the usual cause is mixed bacterial infections.

The condition poses serious problems and treatment is centred on finding the pathogenic bacteria, starting a sensitive antibiotic preferably intravenous and preventing progress of symptoms.
Since the condition is commonly associated with diabetes, his blood sugars need to be checked and if abnormal that needs to be treated immediately.

If the condition is rapidly progressing, he might need an emergency debridement (surgical) procedure. Amputation would be the last option if the progress is very rapid and other conservative treatments are not yielding good response.

This problem concerns me. And hospitalization may be beneficial.

Hope this answers your query. I will be available to answer follow up queries if any.

I wish your father a safe and speedy recovery.

Best Regards
Dr. Prasad