[34F] With swollen legs, red blotchy itchy spots, and pain while walking

Patient Description

A 34-year-old female has been experiencing swelling in her legs, along with red blotchy spots that itch and are tender to the touch. The pain is described as a dull, achy sensation that feels hot and has been present since yesterday, with a pain severity rated as 7 out of 10. The itching is triggered by touch and feels similar to mosquito bites. The swelling started late Friday night and is becoming more uncomfortable, with red spots that feel warm and tender, especially when walking. There is also a light burning sensation from the ankle up about 3 inches. The patient has not had any recent injuries or accidents and has not been around anyone with similar symptoms. Benadryl helps to relieve the itching. There are no streaking red lines, fever, chills, blisters, or open sores in the swollen area. The pain worsens when standing up and walking. The patient's medical history includes asthma (diagnosed around 2001) and GERD. She is allergic to morphine, ibuprofen, Keflex, Vicodin, and penicillin. Current medications include Albuterol (used about twice a week) and Pepcid as needed for GERD (every other week if needed). No other medications, supplements, or herbal remedies are being taken.

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Arora's Assessment

What might be happening

Based on the information you provided, here are some possible explanations for your symptoms:

  • Cellulitis: This is a bacterial skin infection that can cause redness, swelling, warmth, and pain in the affected area. It often occurs after a break in the skin, although this isn't always noticeable. Given the warmth, redness, and tenderness you described, this could be a possibility.

    • Treatment: Cellulitis typically requires antibiotics. It's important to see a doctor for an accurate diagnosis and appropriate treatment.
  • Venous Insufficiency: This condition occurs when the veins in your legs have trouble sending blood back to your heart. This can cause swelling, pain, and changes in skin color.

    • Treatment: Compression stockings, elevating your legs, and medications to improve blood flow may be recommended. A healthcare provider can offer more specific advice.
  • Allergic Reaction or Contact Dermatitis: Given the itching and red blotchy spots, an allergic reaction or contact dermatitis could be a possibility. This can occur due to exposure to allergens or irritants.

    • Treatment: Avoiding the allergen or irritant, using antihistamines like Benadryl, and applying topical corticosteroids can help. A doctor can provide a more precise diagnosis and treatment plan.

What you can do

While you wait to see a healthcare provider, here are some steps you can take to manage your symptoms:

  1. Elevate Your Legs: Try to keep your legs elevated above the level of your heart when sitting or lying down. This can help reduce swelling.
  2. Apply a Cool Compress: A cool, damp cloth can help soothe the itching and reduce inflammation.
  3. Avoid Scratching: Scratching can worsen the irritation and potentially lead to infection.
  4. Stay Hydrated: Drink plenty of water to help maintain good circulation and overall health.
  5. Over-the-Counter Medications: Continue using Benadryl for itching, but avoid any medications you're allergic to.

What you should look out for

Seek medical attention promptly if you notice any of the following:

  • Increased Redness or Swelling: This could indicate worsening infection or inflammation.
  • Fever or Chills: These symptoms could suggest a systemic infection.
  • Red Streaks: Streaks extending from the affected area could indicate a spreading infection.
  • Severe Pain: If the pain becomes severe or unmanageable, it's important to seek medical help.

Remember, while these suggestions can help manage your symptoms, it's crucial to consult a healthcare professional for a formal diagnosis and appropriate treatment. If your symptoms worsen or you have any concerns, please seek medical attention immediately.

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6 mo ago


People Also Ask


What are the common symptoms of cellulitis and how is it treated?

Common symptoms of cellulitis include redness, swelling, warmth, and pain in the affected area. It often requires treatment with antibiotics, so it's important to see a doctor for an accurate diagnosis and appropriate treatment.


How can venous insufficiency cause leg swelling and what are the treatment options?

Venous insufficiency can cause leg swelling, pain, and changes in skin color due to the veins having trouble sending blood back to the heart. Treatment options include wearing compression stockings, elevating the legs, and taking medications to improve blood flow.


What are the signs of an allergic reaction or contact dermatitis and how can it be managed?

Signs of an allergic reaction or contact dermatitis include itching, red blotchy spots, and tenderness. Management involves avoiding the allergen or irritant, using antihistamines like Benadryl, and applying topical corticosteroids.


When should I seek medical attention for leg swelling and redness?

You should seek medical attention if you notice increased redness or swelling, fever or chills, red streaks extending from the affected area, or if the pain becomes severe or unmanageable.


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