instruction: hi doctor I have a small formation in my leg which developed approximately before 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 am but now has increased in size to am which is the reason of my concern whenever it itches I only use antiseptic lotions suthol besides I have parkinson disease and I take sleeping pill every night please advice
output: hi I have seen your pictures and well understand your concern you are having lichen simplex chronicus lac it arises because of repetitive scratching or rubbing I could see thickening of the skin with variable flakes lichen simplex chronicus usually described as stable itchy and thickened one or more areas however thickening of the skin occurs on any location that the patient can reach like nape of neck extensor forearms and elbows scrotum upper medial thighs knees lower legs and ankles in your case it involves extensor aspects of ankles cause for lac includes age related dryness venous insufficiency like tortuous veins or pooling of bloods due to prolong 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 age related dryness venous insufficiency like tortuous veins pooling of bloods due to prolong standing weakness of blood vessels wall due to aging eczema in old age due to bath with hot water asteatotic eczema skin biopsy for histopathological examinations and serum immunoglobulin 1 lichen simplex chronicus neurodermatitis lichen simplex chronicus apply xerina cream glycolic acid or moisture cream 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 propysalic of 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 you can also try injection kenacort triamcinolone acetonide 10 my 1 my am intralesional at the three weeks interval should be given by dermatologist try to avoid scratching whenever you feel itch apply moisturizer or dip wet cotton in normal tap water and put over it revert back after a month to a dermatologist online