I have a skin rash on my ankle. It has been there for six months now. I have tried Penicillin, steroid antifungal cream, and cider vinegar as well but it is slowly getting bigger. It is itchy with scaly flaky skin. I feel some fluid inside the red raised dots when I scratch it. It starts to smell after a while.
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Indeed the clinical image (attachment removed to protect patient identity) is more in favor of tinea corporis which is a fungal infection of the body. It also has the potential to spread and using steroid-based creams will add to the resistance of the problem. Kindly mention if there are similar lesions elsewhere, if you keep your feet soaked for longer times and if you keep wearing the same socks.
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Thank you doctor,
I do not find any other areas like this. I change the socks every day and often wear boots if it helps?
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It would be preferable to treat the lesion as tinea corporis. As you have only one single lesion, you can be managed with topical creams alone. However, you need to use them without fail regularly for a minimum of two weeks. The prior use of steroid creams could further increase the time for clearance of the lesion, as the immunosuppressive effect of steroids may last up to three to four weeks.
Fungal infections have a tendency for recurrence if the patient is not compliant with the treatment. Hence, it is strictly advisable to regularly use the prescribed cream with strict adherence. Also, avoid wet work and soaking your feet for longer durations, preferably avoid socks which would cover up to the lesion as it would retain the sweat locally and add to the problem.
Tinea corporis.Treatment plan:
1% Clotrimazole cream (Lotrimin/ Canestan should be available OTC ) or Terbinafine cream (Lamisil OTC). To be applied on the lesion and up to 2 cm beyond the border twice daily for up to two weeks.
2) Tab Loratidine 10mg (Claritine OTC) or Levocetrizine 5mg
Once daily, after dinner, for 2 weeks
Avoid shoes and socks. Avoid soaked feet and wet work.Regarding follow up:
Review after two weeks.
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