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What Causes Dry Scaly Patches On Legs?

Posted on Tue, 31 May 2016

Question: from past couple of weeks I see small round patches on my legs and hands, it's weird but it never happened before. I used cream Nadisone cream and it worked but new patches are coming up, so not sure if I have to go through the complete treatment. FYI, NO PAIN, NO ITCHING, from beginning the patches are dry but looking good.

Answered by Dr. Dr. Kakkar (37 minutes later)

Brief Answer:
Possibility of psoriasis vulgaris

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar (dermatologist). I have gone through your query and I have noted your concern.

I can see dry scaly patches on legs. This seems like a case of psoriasis.

Do you have scalp involvement too?

I suggest you to use a combination of calcipotriol 0.0003%+clobetasol propionate 0.05% combination ointment (Sorvate C ointment), twice daily.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (6 hours later)

Thank you Dr. Kakkar.

I don't have scalp involvement. It's only on my legs and hands mostly and some on stomach and on my back.

May I know what was the cause? I am concerned if it's some kind of infection, allergy or skin disease? I am not sure if this common. How long will it take to go away completely.

Your detailed answer would be greatly appreciated. Also, please advise if I have to do any tests? Also, should I stop using the creaming I mentioned in my query?

Answered by Dr. Dr. Kakkar (16 hours later)

Brief Answer:
Psoriasis is immune mediated disease

Detailed Answer:
Hi.

Psoriasis is an immune system mediated disease i.e due to immune dysregulation. It is not an infection or an allergy. The diagnosis of psoriasis is usually made on clinical grounds by the presence of classical plaques or patches of disease, however skin biopsy may be done in order to confirm the diagnosis in doubtful cases. You may arrange for a skin biopsy with a dermatologist near you. I suggest you to use the cream I mentioned, twice daily instead of the one you were using. You should notice improvement in about 2 weeks, thereafter further course of action can be decided on follow up.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (5 hours later)

thank you, very helpful!

I will start using cream effective today. Do I also have to take any pills to cure from inside? Just curious.

Finally, can you please suggest DOs and DONTs. I will try to work on that as well for better results.

Answered by Dr. Dr. Kakkar (21 hours later)

Brief Answer:
Oral treatment is to be decided if their is extensive involvement

Detailed Answer:
Hi.

Various oral/ systemic treatments are available for treatment of psoriasis like methotrexate, cyclosporin and phototherapy etc but they are preferred only in patients with more than 20% of body surface area (BSA) involvement and moreover they require monitoring for side effects and therefore should be used only under supervision of a dermatologist with regular follow up. I suggest that you visit a dermatologist in your vicinity who would assess the BSA of involvement and decide on the requirement for systemic treatment. You should anyways continue with the topical treatment, as suggested in my reply.
There are no specific Do's and DONT's. However, there are certain factor that can exacerbate or precipitate psoriasis are infections like strep sore throat; drugs like painkillers, antihypertensives, antidepressives; stress; alcohol etc

Regards

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. Raju A.T