Reddened ankles PMR related or not ?

[tiredbutoptimistic]

Dear colleagues

PMR affects so much of our lives there is a temptation to attribute its impact to pretty much anything going on with ones health, so I may be putting two and two together and making six but I wondered if there could be any PMR link to a rather odd condition I have had for about 2 years?

Both my ankles and lower legs from about 6 inches below my knees have large bright red patches. They don't itch or hurt, the skin is smooth and when you press the skin the redness goes white and then comes right back. Heat and cold make the patches brighter and the spread and intensity of the redness can come and go a bit - but it has been constantly there for a long time. Its not very pretty but other than its appearance it doesn't really bother me. It started before major PMR symptoms started and before my official PMR diagnosis but looking back I did have some PMR symptoms before I suddenly found I could not get out of bed.... It looks quite but not totally like this photo taken from the web pcds.org.uk/clinical-guidan... but isnt connected with exercise.

I'd be very grateful for any thoughts/suggestions if there might be a PMR link - or even pointers if there isnt as it seems to be stumping my very helpful and very good GP.

In case relevant - I'm currently on 11mg of pred (have been for a while as so much is going on in my life tapering did not seem sensible at the moment) and am also on adcal, omeprozole and alendronate and thyroxin as well as a range of other non-PMR drugs that I have been on for years.

I remain eternally grateful for this website and the very kind people on it - I have learnt so much that has been invaluable.

[piglette]

I suppose one comment I have is taking more than five different drugs, (polypharmacy), can increase the risk of adverse drug interactions, side effects, and other problems, especially in older adults.

[SnazzyD]

Are your legs swollen even slightly? How is it not quite like the the picture in the link?

[tiredbutoptimistic in reply to SnazzyD]

Many thanks - it is not quite the same as the internet picture in that the edges of the red are softer - it look less like a rash ON the leg and more a part of the leg that is red. There are also a few white spots in the red - you should be able to see one in the photo above that appear periodically and are a bit sore if I press on them. The legs aren’t particularly swollen unless at the very end of the day when I’ve been on my feet a lot. This started before I was diagnosed with PMR, but looking back, I had some PMR symptoms before it suddenly got really bad and I couldn’t get out of bed. I was on several medications at the time it started, but nothing I hadn’t been previously taking for many years - simvastatin, losartan potassium certirazine hydrochloride and various allergy and asthma preventer inhalers.

Lower leg photo

[SnazzyD in reply to tiredbutoptimistic]

I agree with PMRPro’s point about referral. Have you ever had a Doppler study of the vessels to check circulation?

[tiredbutoptimistic in reply to SnazzyD]

No I’ve not had any study of the blood vessels - originally my GP wasn’t that interested but recently I went back and said I really wanted to get to the bottom of this hence trying a treatment for eczema (which made no difference). One other thing I have remembered is I had shockwave therapy in that same general area (both legs) for planta fasciitis about 2 1/2 years ago - but that may be totally irrelevant. It helped a lot with the PF which is pretty much gone now apart from the odd stabbing pain from time to time.

[SnazzyD in reply to tiredbutoptimistic]

Your GP really ought to refer you. It might be a dermatological issue with or without an underlying vascular issue, but you need to be seen by somebody. I would press for more investigation.

[tiredbutoptimistic in reply to SnazzyD]

I’ve a phone call with the GP tomorrow morning so will seek a referral as you suggest and will report progress. Thanks so much

[PMRpro Ambassador]

I think I might expect to be referred to dermatology at least but if there is any possible link to the PMR, then your GP should be asking a rheumy. He should be able to speak to a rheumy for advice and can send images of your rash.

Can you put up a picture of yours? Did it start before the PMR symptoms? Were you on any medications at the time?

[tiredbutoptimistic]

just a quick update - GP very disappointed the eczema cream had had no effect on my legs and I’ve been referred to a dermatologist, so fingers crossed we will know what this is in the not too distant future.

[PMRpro Ambassador in reply to tiredbutoptimistic]

About time too. Do let us know what transpires.

[DorsetLady PMRGCAuk volunteer in reply to tiredbutoptimistic]

Hope so…