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Lower Leg Rash
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Lower Leg Rash

When doing strenuous hiking in hot weather, a blotchy rash appears on top of foot and up the leg starting just above the ankle area (ankle area stays completely clear of rash.  If the hike is long and hot , the rash will become solid starting above the ankle and progress upward  'filling in the splotchy rash".  It is a burning rash and hot to the touch which fades over time, length depending on severity.  Cool water relieves some but Cortaid creams help the most.  It doesn't matter the type of socks or height of my hiking boot.
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242489_tn?1210500813
Sorry, but I'm drawing a blank.  It certainly isn't a fungus.  It could be some form of contact rash, probably not an allergy but just an irritation due to heat and sweat.  However, I don't have a clear enough picture of the geography of the rash, and your description doesn't sound like any rash I can recall seeing.  I think you're going top need to show it to a skin doctor, perhaps by taking some good photos of the rash when it's at its worst.

Just a thought--in case this is some form of hive reaction to heat, try taking 10 mg of Claritin (OTC) a couple of hours before a hike to see if that mitigates or blocks the redness.

Best.

Dr. Rockoff
11 Comments
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Avatar_n_tn
This could be way off--but I was diagnosed via biopsy with Schamberg's disease a few years ago and just had a reoccurance.  I'm getting it after an overnight flight from North America to Europe, then extensive walking/hiking from the first day I land.  It starts as an intense red rash just above the ankle at the top of my socks.  From there it may spread upward and/or around the leg.  It fades to the classic cayenne pepper spots, then dark brown like freckles, then disappears.  Despite what the medical books say, when it gets so intense it does itch.  My dermatologist prescribed a cortizone or steriod cream plus an antihistimine last time.  This time I didn't want to wait until I got home (and it spread), so I tried a  cream my husband had been prescribed for a rash to keep it under control until I could return home and it completely cleared it up.
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242489_tn?1210500813
Schamberg's disease is fixed--it does not come and go.  Also, it doesn't burn.  If your skin itches on top of the Schamberg's, it's not from the Schamberg's.  Other conditions--eczema, for instance--can occur in the same area and itch.

Dr. Rockoff
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Avatar_n_tn
The description by Linhop is EXACTLY what I experience whenever hiking in heat or extended hours. The severity of the rash is directly related to the intensity of the heat and duration of hike. It starts at the ankle, beneath top of socks, even in low hikers. It is not itchy and fades entirely by the next day or so - I just finished a 10 hour day-hike in hot, dry, So. California mountains and this will take a few days to fade. Is it not enough water, electrolytes, or just being on foot all day? Sports med experts mention symptoms with extreme athletes. I can't find any specific info on what is happening to cause this mainly annoying problem.
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I recently returned from Central Asia where I was doing a lot of hiking in the mountains, and this leg symptom is also what I experienced after a very gruelling hike at high altitude. The rash appeared on both lower legs above the ankle, one more extensively than the other, and has not faded after 5 or 6 days. It is warm to the touch, and creates a kind of stiffness of the skin, perhaps because of mild swelling. It is somewhat painful to the touch.
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Your symptoms sound like what I am experiencing. I was able to see my doctor while the rash was intense and he said that it is actually bleeding under the skin. I haven't had a referral to a specialist yet. I thought that I would just live with it, but now I am finding that too difficult to do. It is especially severe when I go golfing on hot humid days. It occurs after about 2 1/2 hours depending on the temperature and humidity. When the temp. is low, ie. < 68F, I can sometimes golf a full round without any symptoms. Last Monday, it was sunny and 80F+ humidity 60% and I got severe symptoms involving the front and back of the lower legs. Quite often it will appear on the front of the upper legs. Long pants seem to make it worse. I even had chills after I got home. I have found that wearing knee socks will minimize the rash on the lower leg. I have tried taking medication like claritin before golf but it did not help. I am aware of one other person in town who has experienced the same symptoms and she has used the same technique to mitigate the symptoms. The condition seems to be very rare.
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Avatar_n_tn
I get this, too.  Hence, searching the 'Net and coming across this thread.  I'd really like to know what it is.

Yes, indeed, it shows up on both legs, just above my inner ankles, and spreads up and around to the back of my calves, about halfway across.  Its edges are generally sharp, and it starts about the area where "footie" type socks would reach to.  It doesn't itch but it is raised slightly, fully filled in and is more or less solid red in color.  It's appeared on days when I'm outside, in the heat, walking for quite a while.  On all occasions that I can remember, I am wearing sandals and shorts, with no socks.  I went to the doctor last year for it and she prescribed Diprolene AF, a creamy ointment which contains a synthetic cortisone-like steroid. I still have some left and have applied it. It seems to help but not dramatically.  In fact, the rash seems to spread upwards for a time, as the lower edges begin to fade.
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Avatar_n_tn
I get this same rash, in fact I have one right now.  Mine looks like small drops of blood just under the skin around the top of my socks.  When it gets bad it feels hot and tender.  This happens like clockwork every time I go to a theme park and stand on hot pavement all day, or if I'ts warm and I am on om feet all day.  I have seen other legs like this at theme parks and have let them know about it.
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Avatar_n_tn
I get this same kind of angry red rash (splotchy, bright red, feels hot and tight) around my ankles and lower legs after standing or walking in the heat for long periods. I suspect it may have something to do with dehydration and maybe poor circulation. It looks like a bunch of tiny broken blood vessels joined together. I've had it off and on for several years and I just ignore it for the most part, even thought it does look rather ugly.
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Avatar_n_tn
I also get this same rash.  It always appears after I have spent several hours walking.  Most of the time the weather is pretty warm when it appears and it doesn't matter if I have on sandals or socks so I know it's not the detergent I'm using in the laundry.  Mine never itches or burns but is just really annoying and unsightly.  Yesteday I spent most of the day at the State Fair and I wore some support socks per the advice of my doctor.  The socks made no difference whatsoever.  The rash still appeared and is still bright red today.  It looks like blood is on the surface of the skin in certain pores, not solid.  I would love to know what this condition is but neither of the two doctors I have seen seem to have a clue.  I have tried Elidel on the rash but it really doesn't seem to make a difference.  After about 3 or 4 days the rash begins to fade from bright red to brown and then it's gone.
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