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Suggest Treatment For A Brown Patch On The Leg

Posted on Fri, 22 Jul 2016

Question: I have a brown patch on my leg below my knee betwee the caf an shin. It started as a small bump 6 years ago but now it has spread. I have used betacream on it last year and most of it went away but it is back this year and the cream is not as effective.

Answered by Dr. Asmeet Kaur Sawhney (1 hour later)

Brief Answer:
Seems to be bowen's disease, go for clinical examination & skin biopsy

Detailed Answer:
Hi
Thanks for being at healthcaremagic
I have reviewed the attached photograph and there are few possibilities like bowen's disease or psoriasis.
But since it has stopped responding to betacream which is a potent steroid cream there are high chance of it being bowen's disease.
It is a premalignant condition of the skin characterised by scaly or crusted erythematous plaques.
I would recommend you to consult a dermatologist and get it examined clinically and even go for a skin biopsy to confirm the diagnosis so that treatment can be started accordingly.
Regards
Dr Asmeet

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Asmeet Kaur Sawhney (8 hours later)

I have seen two GP one who gave me the beta cream last year said that it was psoriasis but the other doctor was unsure on what it was but assured me that it wasn't cancer. It started as a small bump 5 or 6 years ago and has spread. Lighter in the winter and darker in the summer. It is not crusted.

Answered by Dr. Asmeet Kaur Sawhney (29 minutes later)

Brief Answer:
Site, appearance and no response to beta cream favours bowen's disease

Detailed Answer:
Even I have kept the possibility of psoriasis but its non response to beta cream, site of occurence and appearance goes more in favour of bowen's disease.
Moreover bowen's disease is not a cancer. It is a premalignant condition which can progress to malignancy over a period of some years.
I would recommend you to go for a skin biopsy to confirm whether it is psoriasis or bowen's disease.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Asmeet Kaur Sawhney (23 minutes later)

Could it be sebbhoric Keratosis

Answered by Dr. Asmeet Kaur Sawhney (1 hour later)

Brief Answer:
Could be seborrhoic keratoses though less likely

Detailed Answer:
Yes it could be seborrhoic keratosis though less likely.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Asmeet Kaur Sawhney (8 minutes later)

Why? It is not crusted. My doctor was not concerned. Seborrheic keratosis does not respond to betaceam. This responded last year but not as well this year.

Answered by Dr. Asmeet Kaur Sawhney (33 minutes later)

Brief Answer:
Seborrhoeic keratoses is usually not crusted

Detailed Answer:
Welcome back Dear,

Seborrhoeic keratoses is not always crusted. It can be non crusted and non-scaly.

Moreover your plaque is looking little scaly and not crusted. So I thought more in terms of bowen's disease.

Seborrhoeic keratoses doesn't respond to beta cream. That's why I said that it is not looking like seborrhoeic keratoses as in your case it responded to beta cream in the beginning.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Asmeet Kaur Sawhney (1 hour later)

Does Bowens disease respond to betacream?

Answered by Dr. Asmeet Kaur Sawhney (1 hour later)

Brief Answer:
In the beginning it might respond

Detailed Answer:
In the beginning it might respond to betacream but not in later stages.

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Arnab Banerjee