[38M] With ankle swelling and discoloration

Patient Description

A 38-year-old male reports swelling and purple discoloration around the ankle for two weeks, accompanied by itchiness and peeling skin. The symptoms appeared suddenly and are gradually improving. This is the second occurrence in two years. The patient has a history of cellulitis diagnosed two years ago. Currently, he is taking Bactrim and Januvia, which were started yesterday. No recent injuries or changes in activity, and no known allergies. No other symptoms reported.

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Arora's Assessment

What might be happening

Your symptoms could be related to several conditions:

  1. Cellulitis Recurrence: Given your history, the swelling, discoloration, and itchiness might indicate a recurrence of cellulitis, a bacterial skin infection. This can cause redness, swelling, and sometimes peeling skin.

  2. Venous Insufficiency: This occurs when veins have trouble sending blood from your limbs back to the heart, leading to swelling and discoloration.

  3. Drug Reaction: Although less likely, starting Bactrim could cause skin reactions, including itchiness and peeling.

Typical treatments for cellulitis include antibiotics, which you're already taking. Venous insufficiency might require compression stockings and lifestyle changes.

What you can do

For Swelling and Discoloration:

  • Elevate your leg: Keep your leg elevated when sitting or lying down to reduce swelling.
  • Compression: Consider using compression stockings to help with blood flow.

For Itchiness and Skin Peeling:

  • Moisturize: Use a gentle, fragrance-free moisturizer to soothe your skin.
  • Avoid Scratching: Try not to scratch the area to prevent further irritation.

General Care:

  • Monitor Symptoms: Keep track of any changes or worsening of symptoms using MDandMe to journal and share with your healthcare provider.
  • Stay Hydrated: Drink plenty of water to help your skin heal.

What you should look out for

Seek medical attention if you notice:

  • Increased redness, warmth, or pain in the area
  • Fever or chills
  • Rapid spreading of discoloration or swelling

Remember, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago

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People Also Ask


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

Common symptoms of cellulitis include redness, swelling, warmth, and pain in the affected area, sometimes accompanied by fever. Treatment typically involves antibiotics, rest, and elevation of the affected limb.


Can venous insufficiency cause similar symptoms to cellulitis, and how is it managed?

Yes, venous insufficiency can cause swelling and discoloration similar to cellulitis. It is managed with lifestyle changes, compression stockings, and sometimes medications to improve blood flow.


What are potential side effects of Bactrim that I should be aware of?

Potential side effects of Bactrim include skin rash, nausea, vomiting, and in rare cases, more severe skin reactions. It's important to monitor for any new symptoms and consult a doctor if they occur.


How can I differentiate between a drug reaction and a recurrence of cellulitis?

A drug reaction often includes widespread rash or hives, while cellulitis usually presents with localized redness and swelling. Consulting a healthcare provider is crucial for accurate diagnosis and treatment.


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