What you describe indicates that your husband is experiencing a “tingling, burning sensation” of his skin. That the skin appears dark red and feels hot but that there is, “no rash”. I will assume that the dermatologist concurs that the dark red appearance is not a rash. In that case, what your husband has may not be a skin condition but more a sensation, the medical term for which is paresthesias, that originate in the peripheral nerves, at or near the surface of the skin. (see next paragraph re peripheral neuropathy) Such sensations have been described by roughly 3-4% of persons using either Spiriva or Formoterol (in the Symbicort). That may be the cause and the information I found on this suggested that while a nuisance, this is not considered a serious reaction and not a reason to discontinue the medication.
Another possibility would be that this peripheral neuropathy is secondary to a disease other than emphysema and the most common of these would be Diabetes Mellitus (DM). This can be both annoying and anxiety-provoking and obviously has you and your husband quite worried. For this reason, I recommend that he be tested for Diabetes and, if he does not have DM, that you request consultation with a neurologist, who will probably be able to identify the cause of the tingling and burning. What you describe is almost certainly not serious of itself or as a sign of more serious disease but it would be comforting to know that for sure, so you should get a neurologist’s opinion.
Good luck
I am 65 years old, I too have the burning, tiny poking sensation in my ankles, accompanied by the redness and either dry flaky skin or a slight rash. I have had this for several years. I was recently diagnosed with COPD. While researching COPD I found these symptoms listed in the COPD symptoms.by inputting key words COPD symptoms into Google..........J.R
Thank you very much for your reply Dr Tinkelman. We are very relieved that finally someone seems to have an idea of what could be wrong. My husband will contact his doctor for the DM test and referral to a neurologist as you suggest.
Many thanks once again.