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    What causes a splotchy red rash on the inner left leg?

Posted on Tue, 31 May 2016 in Veins and Arteries
Question: I have a rash on my inner left leg starting at about the knee joint and going down toward the ankle. The rash is splotchy, and spots are reddish and somewhat circular in nature. They look like someone used a piece of sandpaper to make them. They do not hurt and they are not rough to the touch but they are spreading. A few spots are starting on my right leg also. Note: On Oct 15th, 2015 I had major lumbar surgery which did not go well and I needed a re-do on Nov 15th. I have been on Hydrocodone for 10 months for pain which pain is still very much on-going and at a level of 7/8. Also, from the operation I have numbness & tingling in both legs from the knee down (probably neuropathy). .
Answered by Dr. Mukund Savaskar 2 hours later
Brief Answer:
Spreading non itchy Rash on both legs / Under Evaluation

Detailed Answer:
Brief Ans-Spreading non itchy Rash on both legs / Under Evaluation

Hi Dear !! Thanks for your query to HCM.
Read and Reviewed facts of your query in full details, along with its notes and medications tried.
As Your query doesn't specify since when this rash aggravated-Whether since before Lumbar Surgery / of after Surgery?-I would need further details about it to plan further treatment for you.So please provide this information with any other, to be discussed during the next session.

My Opinion-
Based on the facts of your query,the splotchy reddish rash below knee and the postoperative -numbness and tingling in both the legs- has no relation to each other.The earlier is of Venous Origin and the later is of Neural Compression- origin..

If the rash is spreading more post-surgery then One has to think about the post-surgery DVT, as a cause of aggravation of the reddish spreading rash on left leg and start of red spots on right leg also.

In brief it seems to be -Venous reddish Rash ( ?with Eczema which is Doubtful - as you don't have any itching) with Varicosity of leg veins and needs to be investigated accordingly from Vascular Surgeon.

Do's suggested for you-
In view of the facts -You should stop the Steroid Cream , as it would give a false sense of treating it, though you are complicating it more.

Please Consult Surgeon who would assess this spreading rash and would get Colour Doppler & USG of the leg Veins to find it's cause- as discussed above.

Final Consultation with Vascular Surgeon should fix the cause and would resolve the issue by needful treatment in your case.

Hope this would help you to plan further treatment with your doctors there and to get it resolved soon.

If satisfied with this reply, few feedback comments to express your satisfaction, would boost the morale of the incoming patients like you at HCM Virtual Clinic.

Good Day !!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist

Above answer was peer-reviewed by : Dr. Arnab Banerjee
Follow up: Dr. Mukund Savaskar 16 hours later
I'll need some translation here in order to understand the answer.
What does "Venous Origin" mean?
What does "Neural Compression Origin" mean?
What's a "Colour Doppler & USG"? What does it involve? Would such a test be justified particularly at this point since I have NO pain, or fever or even itching? Are pain and itching or any other more serious symptoms likely to come?

The spots began showing up about 3 weeks ago - well after the surgery of 4 1/2 months ago.
Answered by Dr. Mukund Savaskar 1 hour later
Brief Answer:
Your Case needs Assessment of Spreading non itchy Rash on both legs !!

Detailed Answer:
Brief Ans-Your Case needs Assessment of Spreading non itchy Rash on both legs !!

Hi Dear !! Thanks for the updates and the queries with it.
Read and reviewed your query in context to the updated queries and your health concerns.
Based on the facts of your query and its updates-following are the replies to your updated queries-
Q-1-What does "Venous Origin" mean?
Ans-It means that the splotchy red granular rash is due to the incompetent Leg veins below knee up to ankle.In short it means- that the rash is result of the incompetent Veins of leg below knee.

Q-2-What does "Neural Compression Origin" mean?
Ans-It means that, numbness and tingling after redo Lumbar-surgery is from Neural Entrapment in the lumbar region.

Q-3-What's a "Colour Doppler & USG"? What does it involve?
Ans-Color doppler -is a machine which records the amount of red(Arterial ) and blue (Venous) blood in the vessels of the legs.
USG- is the Ultrasound Sono-Graphy- is the study of the leg Veins with Ultrasound waves, which would indicate the severity of the back flow of the Venous flow from the abdominal veins in to leg veins in your case / or from the thigh veins in to the leg Veins.
With Suspected Deep Vein Thrombosis- DVT (Deep Veins Thrombosis)of the Leg veins-caused from long term immobility during the redo- lumbar - surgery you had lately, you have regurgitation of the Vein flow, from blocked vein with excessive vein blood flow through the Veins of your legs.

Q-4- Would such a test be justified particularly at this point since I have NO pain, or fever or even itching?
Ans-Though You don't have pain and itching at this point of time, the Varicosity / or DVT could aggravate if not treated properly at expert hands of Vascular Surgeon,at the Earliest time possible.

Q-5-Are pain and itching or any other more serious symptoms likely to come?
Ans-For your advanced age, there is very high risks from Pulmonayr/ Coronary Embolism from the the thrombosed Deep Veins of your leg or from the Ulcerations from the Varicose Veins in the legs.
Prolonged bed ridden condition due to redo- lumbar surgery could lead to DVT causing Varicosity in the superficial leg Veins in your leg.The incompetent blood flow in such Varicose Veins leads to suffusion of blood flow causing Venous Rash,as it is in your case

IN view of the serious risks, these tests and assessment of Rash in your legs is a MUST.
Though the spots began only in last 3 weeks and after 4.5 mths time of Lumbar Surgery,as there is risk of serious complications endangering your life in time to come, there is a definitive need of assessing your leg rash urgently to avoid / prevent the above sited complications from Deep Vein Thrombosis of leg veins in your Case.

Hope these replies would help you to plan further treatment urgently from doctors in your area, so as to reduce the life risks from thrombo-embolism from the Deep Vein Thrombosis , which needs to be controlled and treated in the early stage itself.

Welcome for any further query in this regard.
In case you are satisfied, few pleasing feed back comments from You,for rating this service from Me would boost the morale of the incoming patients like you at HCM virtual Clinic.

Good Day !!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist

Above answer was peer-reviewed by : Dr. Naveen Kumar
Answered by
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3607 Questions


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