Had a swollen calf and foot. Have painful rash with fluid oozing. Blood test and ultrasound normal. Suggest?

Posted on Mon, 3 Jun 2013 in Skin Hair and Nails
Question: Hello Doctor....I have had a swollen calf and occasionally the foot also for 6 weeks. I also have a rash which one doctor said was Eadema. It sometimes itches and most always is painful. Tonight it is oozing clear liquid. I have had four doctors just shake their heads. I have had blood tests and two ultrsounds. All good results. I do have an appointment with Dermatologist on Friday morning but the latest symptom, the oozing water, has me uneasy. YYYY@YYYY
Answered by Dr. Johny Chacko 20 minutes later
Welcome to healthcare magic
It looks like you are having pedal edema over both lower legs associated with eczema and now because of scratching you got wounds in the leg, which got secondarily infected. Sometimes even without secondary infection when you get wound over the edematous leg, edema fluid keeps oozing out through the wound.

You mentioned that you have trouble with platelets. Even low platelet count can prevent blood to clot and thereby increasing the oozing.

You have a feature to upload the images by yourself at the right side of the query page, please utilize that so that I can answer your query better. You can also send the image as attachment to YYYY@YYYY , with the subject as 'Attn: Dr. Johny Chacko'.
Hope I have answered your query. If you have any further questions, I will be happy to help.
Wish you good health.

Above answer was peer-reviewed by : Dr. Shanthi.E
Follow up: Dr. Johny Chacko 7 hours later
I have an appointment with a Dermatoligist on Friday. This being only Wednesday is there anything i can/should do until them? Thank you.
Answered by Dr. Johny Chacko 59 minutes later
Welcome back XXXXXXX

I gather it is not possible for you to upload a photo. The purpose of asking you for the photo was to assess whether the leg is infected. If there is infection it is better to start on a course of antibiotics from your primary care physician before the dermatology appointment. Redness, pain, fever and yellowish discharge indicates infection.

I will mention some things which you can do. It is better to take bed rest. Elevate the limbs above the level of your heart. When you are sleeping elevate limbs with a pillow. Do not hang the limbs down as it will increase the swelling and oozing.

You can take anti histamines for itching and paracetamol for pain.

Keep the oozy area clean. You may apply warm saline compresses which will decrease pain and swelling two to three times a day.

Hope I have answered your query. If you have any further questions I will be happy to help.

Take care
Above answer was peer-reviewed by : Dr. Mohammed Kappan
Follow up: Dr. Johny Chacko 3 hours later
Sorry...these are not the best pictures. I am on an antibiotic and I will elevate my leg. Thank you so much.
Answered by Dr. Johny Chacko 5 hours later

Thanks for the photographs. It looks infected. It is good that you are already on antibiotics. Please continue antibiotics.

Both lower limbs are quite significantly swollen. The reason for swelling should be established and tackled. Otherwise you may get similar episodes again later.

The location of the wound is commonly seen in venous inefficiencies. You have mentioned that you did two scans, if venous Doppler has not been done I would recommend that.

Other causes of bilateral limb swelling are renal problems, anaemia, liver problems, hypertension, cardiac problem and pelvic swellings which needs to be ruled out.

Hope I have answered your query. If you have any further clarifications I will be happy to help.

Wish you good health.
Above answer was peer-reviewed by : Dr. Raju A.T
Answered by
Dr. Johny Chacko


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