Itchy lower legs and feet

[lotsapets]

For the past several months, I've been plagued occasionally by what I thought were insect bites.  I got nervous about bed bugs, fleas, mites, etc., but could never find any bugs.  When I was at the doctor for another reason I asked him, and he said that they didn't look like bites, but rather like something from inside me--like hives, is what I took him to mean, or an allergic reaction.  Finally, after some internet digging, I asked a dermatologist I had to see for another reason a possibly leading question, and she said that yes, an injured tendon (why I saw the first doctor) can produce a burst of histamines which could cause itchiness and something like hives.  Whether this was the cause of the bumps, I don't know, since there were no new ones to show her, at that visit.  The bumps mostly went away, finally, and their disappearance did seem to be following the improvement of my tendon injury.  But for a week or two now I've been getting intense itching in my lower legs and top of the feet, when I sit at the computer at night.  With the number of pets I have, fleas would be the obvious answer, and yet not one of my pets is scratching or showing any other signs of having fleas, and I don't see any near the floor.  I'm wondering if any of this is adding up.  Could I have a systemic something?  I've never suffered from any form of itchiness until now, and I don't have problems with dry skin.  I'm a 51-year old female with no significant health issues, a little overweight, with a family history of hypothyroid, hypertension, and diabetes.  

[Bhupinder Kaur, MD]

Hello,
In neurodermatitis, cooling lotions like those containing camphor or menthol, capsacain or local anesthetic creams, amitriptyline and gabapentin tablets and electrical cutaneous nerve field stimulation prove effective.
You can discuss these treatment options with your dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[lotsapets]

Thank you very much for your answer.  My wonderful primary care doctor recently left her practice to be the MD in residence at a retirement home, so I have no real doctor now, and value your answer even more.  Since I spend a lot of time outdoors and definitely do get insect bites, and am also under emotional stress lately, I think neurodermatitis could well be the answer, although on some days when stress is worst, there's no itching at all.  I will google all three things you mentioned--all three are new to me, and I will learn a lot.  Thank you again!  

[Bhupinder Kaur, MD]

Hello,
For such symptoms if no rash is visible then neurodermatitis, lichen simplex chronicus and stasis dermatitis should be ruled out. Neurodermatitis develops when nerve endings in the skin become irritated, triggering a severe itch-scratch-itch cycle. Common causes of nerve irritation include an insect bite and emotional stress. I suggest you to get an examination done from a dermatologist and get these possibilities ruled out.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.