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Developed brown pigmentation on lower left ankle area. No itching and pain. Taking warfarin daily. Suggest the cure?

Dec 2013
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Halo doctor, I have developed brown pigmentation over the last couple of years, on left lower foot ankle area, no itch, no pain, started with small dots which have coalesced into patch. I take warfarin 5 mg everyday for atrial fib
Posted Wed, 23 Oct 2013 in Skin Hair and Nails
Answered by Dr. Sanjay Kumar Kanodia 29 minutes later
Brief Answer:
Do not worry it is normal condition

Detailed Answer:

Welcome and thanks for posting your query to XXXXXXX

As per your query you have brown pigmentation on left lower foot and ankle area from last couple of years without any itching and pain.

Considering your history with diligence I can make out the best and closest possibility of "Schamberg Disease" or medically known as "Progressive pigmentary dermatosis" or PPD.

It is a very common problem in post middle aged persons. It occurs due to extravasation of red blood cells from the small blood vessels of skin. The thin blood vessels near the surface of the skin which are also known as capillaries are thinned out due to aging factor. These thinned vessels permeate the red blood cells to extravasate into the skin.

The red blood cells after deposition into the skin releases the iron content and this ultimately causes a brownish color of the affected area.

It can affect both the legs or can affect one leg which is more prone for the same. As you are taking warfarin also so this is also one of the contributory factor in increasing the permeability and so the discoloration.

This is totally a normal condition and there is no need of taking any treatment for the same. Some times if the patient is quite panicky then we prescribe Kojic acid cream or Azelaic acid cream to be applied at night.

Vitamin C is also helpful in improving the strength of the blood vessels so you can take Vitamin C supplementation also.

Hope these informations will help you. If you have further queries I will be happy to help.

"Wish you good health"

Dr Sanjay Kumar Kanodia
MD (Dermatology)
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