Brief Answer: Chilblains/Perniosis Detailed Answer: Hi. Thanks for posting your concern at HCM I would like to keep a possibility of Perniosis/chilblains Chilblains (pernio) is a benign condition that occurs in cold, damp environments and presents with symmetric, distal, transient red-to-purple lesions on the extremities. Chilblains is a consequence of prolonged vasoconstriction of peripheral blood vessels in response to cold leading to mild tissue hypoperfusion and localized inflammation in response to tissue injury Lesions are more common on the dorsal aspects of the digits (fingers and toes), and may be pruritic, painful (burning or tingling). The nose, lips, ear, lateral thighs, and buttocks may also be involved. Treatment is centered on keeping the body warm and avoiding exposure to cold, damp environments. Maintaining core body temperature warmth is essential, but layering warm garments over the affected or disease-prone extremities is important as well. Individual lesions will often resolve with warming, though it often requires days to a few weeks to completely return to normal. A topical antibacterial+steroid combination cream/ointment (flutivate+mupirocin ointment) will help to bring down swelling and inflammation. Oral Antibiotics may be required if the lesions have become infected. Oral Nifedepine which is a vasodilator is given sometimes in a dose of 20mg twice or thrice daily to help counter the vasoconstriction of blood vessels regards take care

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Brief Answer: Possibility of Fungal Infection Detailed Answer: Hi. Thanks for the additional information. That leads us to a second likely possibility of Tinea, fungal infection. Constant wet/ moist feet (as in your case) can predispose to fungal infection of the feet.. Body folds e.g Toeweb spaces, groins etc presents an ideal environment for the fungus to grow (warm, moist and humid) specially in summers and more so in coastal and tropical areas e.g where body sweats a lot. The moisture gets trapped in between the folds, thus favoring fungus growth. It usually presents as itching and scaling of the skin, blisters can also develop in inflammatory tinea pedis. Fungal infection can be confirmed with skin scraping test and KOH and visualizing under the microscope for fungal elements Antibiotics obviously wont help in case of fungal infection. Treatment for a fungal infection is based on: -Antifungal creams: Either Clotrimazole/Ketoconazole/Sertaconazole OR Luliconazole for 4-6 weeks -Antifungal tablets: Fluconazole/Itraconazole for 4-6 weeks -An oral antihistamines like either Cetrizine/Fexofenadine or Loratadine can be taken once or twice daily symptomatically, for the itch associated with fungal infection -An antifungal dusting powder like Clotrimazole dusting powder is an important part of treatment and for prevention of relapse/recurrence of infection, because frequent dusting with an anti-fungal dusting powder not only keeps the area dry but also inhibits the fungus from regrowing (being an antifungal). More than the treatment it is the prevention of recurrence of fungal infection that is the main concern. I would advice that you get a skin scraping for fungus, to confirm the diagnosis Hope this answers your query regards

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Brief Answer: Upload a picture Detailed Answer: Hi. I would like, if you could please upload a clear picture (may be 2-3 clear pictures) of the affected area for me to be able to have a look at, so that i can help you better. Kindly also let me know the treatment that you have been using for it (oral as well as topical). regards

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Brief Answer: Eczematous dermatitis with Secondary bacterial inf Detailed Answer: Hi. Thanks for the pictures. It really makes a difference. I would now keep a possibility of, Eczematous dermatitis with Secondary Bacterial Infection, probably due to scratching. It does'nt look like fungal in the picture. I could also see that some of the area (on the outer part of the patch) may have been oozing and forming crusts Moxyclav duo is an oral antibiotic, probably was given for secondary bacterial infection in the past Looking at the present condition, I would advice that you take Moxiclav Duo for 5 days, twice daily to take care of the infection and oozing/crusting. I would also like to add a topical steroid+antibacterial combination cream/ointment (e.g flutivate+mupirocin combination ointment OR Clobetasol+Neomycin ointment) twice daily for 2 weeks. A short course of oral steroids in a dose of 32 mg Methylprednisolone once daily after breakfast for 7-10 days, would really help in bringing about rapid relief. Also take an oral anti-acid empty stomach/before breakfast along with it, as long as you take the oral steroid. An OTC antihistamine e.g cetrizine 10mg, once or twice daily, would help you symptomatically. I hope this would be of great help to you regards

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