Help with skin condition

[abba1234]

Dear Sir/Madam,

I have had an itchy skin condition on my leg for more than a year. Doctor has prescribed both anti-bacterial and anti-fungal medication - both have not helped.

Can you provide me with a means to send you a photograph.

Questions:
1. What do you think it is?
2. What should I do next?

Mr Abba

[Dr Jonathan Bowling]

Dear Mr Abba,

Unfortunately we are unable to accept images for diagnosis - we can only give broad advice.

If the area is localised on one leg then it may be a fungal or inflammatory condition.

Topical antifungals containing terbinafine may help treat tinea - a common fungal rash on the skin.

If it is an imflammatory condition then soap avoidance is very imprtant as this will aggravate the condition. Topical mositurisers and steroids may have to be used for some time until symptoms clear. The strength of steroid may have to be increased if there has not been any effect and conversely if improvement occurs reduce the strength of steroid and reduce the frequency of application.

2 tips that may also help:
1. Apply ointment to the legs in direction of hair growth, i.e. from hip to toe and do not rub in the creams.
2. Applying the steroid on top of the moisturiser to improve ability of spreading the steroid evenly.

If there has been no improvem,ent then I woul dsee you GP again for consideration of referral to a skin specialist.

I hope this helps

[abba1234]

Thank you - much appreciated. I will give my GP one more visit tomorrow and see what he says.

[Dr Anton Alexandroff]

Dear Mr Abba,

I totally agree with Dr Bowling that we can only offer a very broad advice without seeing your rash in person. There are of course different strengths of antifungal topical preparations and steroid topical preparations available.
On a different note, I personally recommend make a gap between applying an emollient and a steroid topical preparation otherwise you may dilute steroid topical preparation. Another tip is that ointments are greasier and generally work better then creams and lotions which are less greasy. This is because greasier topical preparations get into your skin better.

And of course it is very important to avoid soaps and shower gels(and bubble baths!) long term - consider to wash with emollients e.g. dermol 200 shower emollient, E45 Emollient Shower Cream, diprobase cream, Oilatum Shower Gel (which is actually emollient), cetraben. A very good antiseptic emollient to wash with is Eczmol.

How did you visit to your GP go?!

I hope this is helpful.
With best wishes,
Dr Anton Alexandroff MRCP(UK) PhD FAAD FRSM
Consultant Dermatologist in Leicester and Bedford
www.alexandroff.org.uk
twitter @bedford_skin_dr
blog: http://privatehealthnews.co.uk/category ... rmatology/