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Dermatology/Bilateral LE ulcers


Dr Fisher,

I am a 56 yr old male, overweight, with some circulatory issues.  In fact last December I had triple bypass surgery.  My job required me to be on my feet 8 hrs/day and I developed edema and painful venous ulcers on both lower legs.  I have attempted to use compression stockings and wraps to control the edema but I am rather ashamed to admit that my obesity as well as joint stiffness will not allow me to reach to put them on.  And I have no 'significant other' or anyone living with me to do it for me.

The real reason I am writing is that something new has developed.  Next to one of the sores on my left leg
a blister has appeared.  I have not done anything to cause a burn, or anything to cause a blister such as this.  It is approximately 1/2 inch in length and maybe 1/4 inch wide.  I should also mention that both lower legs are dark red, and at times my feet appear to be turning black, but not completely yet.  I'm sure that you are wondering by now if I have seen a doctor; and the answer is yes.  I was visiting a Wound Care clinic for awhile to address my venous ulcers, but stopped going after a couple of months because I was experiencing no improvement.  

I know it is difficult to comment on some issues since you cannot see what we're dealing with and have to rely solely on our description of the problem.  But from what I have told you so far, what is your opinion of what's going on regarding this "new" blister?  I also have a sore on the back of my right calf about the size of a quarter that refuses to heal.  It will scab over but never seems to get smaller, even though I have tried neosporin, hydrogen peroxide, and alcohol at times, nothing seems to help.  

Thank you for your time and your service to  


Venous ulcers are treated with compression of the leg to minimize edema or swelling. Compression treatments include wearing compression stockings, multi-layer compression wraps, or wrapping an ACE bandage or dressing from the toes or foot to the area below the knee. The type of compression treatment prescribed is determined by the physician, based on the characteristics of the ulcer base and amount of drainage from the ulcer.

The type of dressing prescribed for ulcers is determined by the type of ulcer and the appearance at the base of the ulcer. Types of dressings include:

Moist to moist dressings
Alginate dressings
Collagen wound dressings
Debriding agents
Antimicrobial dressings
Composite dressings
Synthetic skin substitutes

Blisters can be cause by your skin disease but if you continues to produce blisters you would need to have a biopsy to make sure you do not have an autoimmune disease like bullous pemphigoid.  


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Michael S. Fisher, <B>Ph.D., M.D.</B>


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