DEAR DR. GOTT: I live in a retirement center and am blessed to be able to attend church groups and other organizations — some for over 70 years. Many try to let my age speak for me but I want to continue to enjoy life as long as possible.
Equilibrium has been a problem and I am now using a wheel chair. I have had surgery twice for cancer but am still searching for help.
I also have extreme itching coming out of the pores of my ankles. For years I inquired of doctors, nurses and a dermatologist with no answers. Some prescribed their favorite ointment or lotion but I have never received any real answers or help. In the beginning only one ankle was affected, then both at the same time. This year a small area appeared on my stomach but soon disappeared. It is dry and will cover my entire ankle. This started after two years of chemotherapy in 1975 and 1976.
I really need some relief and would appreciate your suggestions.
DEAR READER: Let me begin by addressing your concern with equilibrium. Are you are referring to vertigo, a feeling that you or your surroundings are spinning around you? This is commonly linked with a problem of the inner ear but can also be tied with visual disturbances and other issues.
Then there is dizziness and lightheadedness, a rather common complaint experienced as we age. You don’t elaborate on whether the episodes last for any length of time or whether they only occur when you stand too quickly. There are countless possibilities for your condition, to include Meniere’s disease, an inner ear disorder; labrynthitis, an inflammatory bacterial or viral disorder; atherosclerotic vascular disease, that results from a buildup of plaque in your arteries; and a host of other possibilities.
Another possibility is that you don’t have a problem with your equilibrium, but rather a problem with the nerves of your feet and legs. If these nerves malfunction, feeling may be impaired, leading to instability while standing and walking. Given that you have had chemotherapy, this may be the cause.
I recommend you make an appointment with your physician who should give you a complete examination, EKG and order blood work. You may simply have an undetected vitamin deficiency or thyroid disorder that can be handled simply by medication. Or, you may need referral to a neurologist or other specialist for more extensive testing. Once the cause of your loss of equilibrium is discovered, hopefully appropriate steps can be taken to make it an issue of the past.
Now, on to your itching ankles that also are a fairly common malady. Causes can be contact or atopic dermatitis, chronic renal failure, the result of a specific medication you may be on, obstructive biliary disease, or my first thought — eczema.
Eczema is an inflammation of the skin that causes profound itching. It is commonly observed on the arms, feet, ankles, or behind the knees but can be present on any part of the skin. The pattern is a flare up that ultimately subsides — only to repeat all over again. The cause of this condition remains unknown but it is believed to result from inherited tendencies for sensitive skin and because of a malfunction of the immune system when coupled with dry skin.
Symptoms include mild to severe itching, red to brownish gray patches and small bumps that can leak and ultimately crust over. If the skin is compromised through scratching or rubbing, it can become infected by bacteria that live on the skin.
Conditions that aggravate eczema include cigarette smoke, hot baths or showers, stress, dry skin, wearing abrasive clothing, dust and dirt, and eating specific foods such as fish, soy, wheat, eggs and milk.
The only specific testing that can be done to make a diagnosis of eczema is biopsy; however, visual examination by your doctor or dermatologist is typically all that is needed. Treatment is aimed at reducing the itch and inflammation with corticosteroid creams or ointments that can be purchased either over-the-counter or via prescription. Oral antihistamines such as diphenhydramine might also be recommended for severe itching. Should the lesions become infected, antibiotics will likely be prescribed to bring it under control.
On the home front, you might consider changing your bed pillows, quilts, rugs and draperies and other things periodically that collect dust since they are can trigger an attack. Avoid harsh detergents and perfumed soaps. Apply cool, wet compresses to your ankles to reduce the level of itching. Bathe less frequently in warm, not hot, water that has uncooked oatmeal or baking soda added. When you get out of the tub, do not rub your body with a towel but pat it dry to prevent irritation. Moisturize your skin regularly. Do not add any dietary supplements to your daily regimen without checking with your physician first.
I’ve gone on at great length about eczema and may have covered the wrong topic completely; however, whatever the cause for your ankle itch, it should be identified and treated properly. Get your exam and that vital blood work that might answer a lot of questions. Then be sure to visit another dermatologist who should be able to put a name to your itch.
Readers who would like related information can order my Health Report “Dermatitis, Psoriasis and Eczema” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039-0433. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.