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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8419
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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Chronic cellulitis on lower leg. Wraps 2/3 around leg and

Resolved Question:

Chronic cellulitis on lower leg. Wraps 2/3 around leg and 6" high. Hard and crusty, bright red. Swelling above and below area. Been using Bactroban cream which is not helping. The leg has neurological damage due to disk (4-5) surgery which leaves numb areas. Just got over C-Diff with heavy dosage of antibiotics which had no effect on the cellulitis. My research shows that the two problems are somewhat related as per medication. Artery exams ok. Veins showing valve backflow not working in 3 areas--working on this now. Crushed shin vessels 4 years ago which added to the problem. Now what? Am I on the wrong track? Thanks for the input!
Submitted: 3 years ago.
Category: Dermatology
Expert:  Dr. Nair replied 3 years ago.
Hi,

Would you be able to take a photograph of the affected area at your convenience?
Customer: replied 3 years ago.
Yes, I can do that. Just not too sure how to get one picture to you. It may take awhile. Do you want to move on and I will get back to you, or continue. By the way, sorry, My name isXXXXX
Expert:  Dr. Nair replied 3 years ago.
Sure Jackie, take as much time as you want. I check in everyday.

You can upload the pictures to the question box by clicking on the paper clip icon in the question box toolbar. This toolbar does not display in google chrome and safari so an alternate browser may be required.

Another option is to upload pictures to www.photobucket.com or www.picasa.com and send me the link.

If this seems too complicated then just email the photographs to support@justanswer.com with my name (For Dr Nair dermatology expert) in the subject line and they usually forward the mail to me within 24 hours. Regards.
Customer: replied 3 years ago.
Ok. I will get something off to you later today. In the meantime, thanks for the help. I have been living with this thing for years but it usually is a LOT smaller and not so red.
Expert:  Dr. Nair replied 3 years ago.
You're most welcome. Its past midnite in my part of the world and I am calling it a night. I'll check for the photograph tomorrow but as I said there is no rush, take as much time as you need. Regards.
Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Thank you for the photographs. You do not have chronic cellulitis. Your history and clincal picture are typical of venous stasis eczema. Varicose veins along with a rash like you have are typical signs of this condition. The tightness of skin in the involved area and the swelling above it is a complication of long standing venous disease and is known as lipodermatosclerosis.

The problem with this condition is that is does not really improve till the underlying problem (venous blockage) is sorted out. This requires a Doppler ultrasound to determine the extent of the deep venous blockage due to DVT. Its great that you have already had this and the venous incompetence has been documented and the cause found (valve backflow). Depending on the extent of this surgery can be planned to address the problem.

In the meantime compression stockings are the way to go. They should be worn throughout the day everyday barring during sleeping hours.

Besides this keeping the area affected well moisturized and using elocon or 1% cortizone cream mixed with bacitracin ointment twice a day over the patches will help. Tab Claritin 10 mg twice a day will take care of the itching if present.

If there is pus discharge at any point this indicates an infection and needs oral antibiotics. Till you can get the antibiotics vinegar compresses will help - mix half a cup of white vinegar in a litre of tepid water, dip a clean cloth or gauze in it and spread over the affected area. Leave on for 5 minutes and then remove gently wiping off the crust/pus. Do this twice a day. This is not needed presently.

Tab Pentoxifylline 800 mg three times a day or Tab Calcium Dobesilate 500 mg three times a day are also helpful. Both require a prescription.

Hope this information is useful, please feel free to ask if you have any queries.
Customer: replied 3 years ago.
This certainly takes me off in a different direction! Thank you for the diagnosis. It makes a lot more sense than anything else that I have been told in the last 5+ years.

One further question. Is this contagious at all? After showering, I use a dry wash cloth to pat dry the area rather than the towel. My massage therapist is afraid to touch it when it gets this bad.
Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

You're most welcome! No, venous stasis eczema is not contagious and will not spread to your massage therapist. Please feel free to ask if you have any further queries. If you feel that you are satisfied with the answer provided please press the green ACCEPT button. Regards!

Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8419
Experience: MBBS, MD (Dermatology, Venereology & Leprology)
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Dr. Nair
Dr. Nair
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MBBS, MD (Dermatology, Venereology & Leprology)