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What could cause a burn-like mark to increase in size?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I have a small formation in my leg which developed approximately three years. I have attached the images for your reference. It is brown in color, somewhat similar to a burn. It itches sometimes and it is very dry in nature. This formation was initially around 0.8" but now has increased in size to 2.8", which is the reason for my concern. Whenever it itches I only use an antiseptic lotion - Suthol. Besides, I have Parkinson's disease and I take sleeping pills every night. Please advise.

Answered by Dr. Suvash Sahu

Hi,

I am glad you chose icliniq for your medical-related queries.

I understand your concern and will try to help you with it.

I have seen your pictures (attachment removed to protect patient identity) and well understand your concern. You are having lichen simplex chronicus (LSC). It arises because of repetitive scratching or rubbing. I could see the thickening of the skin with variable flakes. Lichen simplex chronicus usually described as stable, itchy, and thickened in one or more areas. However, thickening of the skin occurs in any location that the patient can reach, like the nape of the neck, extensor forearms and elbows, scrotum, upper medial thighs, knees, lower legs, and ankles. In your case, it involves extensor aspects of the ankles. Cause for LSC includes age-related dryness, venous insufficiencies like tortuous veins or pooling of blood due to prolonged standing or weakness of blood vessels wall due to aging, and eczema in old age due to bath with hot water (asteatotic eczema) are common factors.

Thank you for consulting me.

You can always reach me at icliniq.com.

The Probable causes

1. Age-related dryness. 2. Venous insufficiency like tortuous veins. 3. Pooling of blood due to prolonged standing. 4. Weakness of blood vessel walls due to aging. 5. Eczema in old age due to bath with hot water (asteatotic eczema).

Investigations to be done

Skin biopsy for histopathological examinations and serum immunoglobulin E.

Differential diagnosis

1. Lichen simplex chronicus.

2. Neurodermatitis.

Probable diagnosis

Lichen simplex chronicus.

Treatment plan

1. Apply Xerina cream (Glycolic acid) or Moisture cream (a combination of Urea, Liquid Paraffin, Propylene glycol and Lactic acid). Wait for 15 minutes and then apply topical steroids with Salicylic acid should be applied twice daily for two to four weeks and also take one tablet Levocetirizine once daily for similar duration. 2. Propysalic NF lotion (Clobetasol and Salicylic acid combination) occlusive dressing will be more helpful. The method of occlusion is after application of Propysalic lotion put flat polythene cover then cotton bandage and leave it for whole night for two to three days, occlusion is not need in day time. 3. You can also try an injection of Kenacort (Triamcinolone acetonide) 10 mg/ml 0.1 ml/cm^2 intralesional at the three-week interval should be given by a dermatologist.

Preventive measures

Try to avoid scratching. Whenever you feel itch apply moisturizer or dip wet cotton in normal tap water and put over it.

Answered byDr. Suvash Sahu

Medically reviewed byiCliniq medical review team

Published At May 16, 2016
Reviewed AtOctober 15, 2024

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