What causes brown pigmentation and redness near the ankles?

Question

Hi doctor,

My mother is 55 years old. Why does she have brown pigmentation and redness near the ankles? My mother also has varicose veins, which are highly visible on both legs, especially in the picture. Do they pose any health risks? Is there something that can be done? Fifteen years back, my mother was spraying insecticide in front of our main door near the pavement. It was dark, and she was wearing the Bermudas. She did not realize that she was spraying on her ankles or legs too. Large blisters filled with water came within an hour. The pharmacist gave a water-based product for bathing every day until the blisters popped. But the area where one of the blisters located remain pigmented. A couple of months back, she noticed the brown pigmentation on her feet had significantly increased on both legs.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concerns for your mother. I have gone through the images attached (attachment removed to protect patient identity). Let me address your questions one after the other.

1. Do varicose veins pose any problems? : Unfortunately, yes. Varicose veins happen when the valves within the veins (blood channels that return the blood to the heart) are incompetent and not able to perform or push the blood towards the heart. As a result, slow blood stasis occurs, leading to dilation of veins which are easily visible, as in the case of your mother. The brown pigmentation is mainly due to oxidation of hemoglobin of blood, releasing hemosiderin (which is a protein with iron) under the skin giving it the color. Long-standing varicose veins can lead to sore or ulcer formation in the legs, which in turn are a little difficult to treat.

2. Can we do something about it? Absolutely, yes. There are treatment options available like compression bandages, stripping, sclerotherapy. However, your doctor should help you after physically examining the legs and assessing the severity. Accordingly, they may suggest the appropriate option. One suggestion from my end will be to keep the legs elevated while sleeping (use a couple of pillows below the legs) or place them flat over another chair while sitting. Avoid standing for a long time which further aggravates the situation.

I do not think that your mother's present discoloration is anything to do with the use of some liquid applied 15 years back. If blister forms and burst open and deeper layers of skin are involved, there is the possibility of pigmentation. However, I do not see the present brown pigmentation as linked to the past. I hope this brief explanation helps. Please let me know if there are other concerns. I will try to help, albeit remotely. By the way, I would like to know whether your mother has any other medical conditions like diabetes and hypertension.

I hope this helps.

Kindly follow up with details.