Seeking Relief for My Agonizing Foot Condition
I am a 29-year-old female dealing with a frustrating issue for more than twelve months. The intense itchiness in my left foot is driving me to distraction; it's become extremely difficult to tolerate. My next visit to the primary care physician isn’t scheduled until July 23rd, and I'm in desperate need of assistance. Despite applying antifungal cream, I've seen no improvement—nothing alleviates the itching. Additionally, I’ve noticed peeling skin on that foot. During a previous consultation, the doctor diagnosed it as athlete's foot and recommended a topical treatment, but unfortunately, that hasn’t provided any relief. A year later, the itch is still persistent. Recently, I observed some small bumps on the soles where the itching is most intense, along with irritation occurring between my toes. The bumps resemble blisters filled with a clear fluid, and they itch significantly more if they are disturbed. I am at a loss for what steps to take next. I would greatly appreciate any advice or insights. I had shared my situation before, but I didn’t receive any feedback. Thank you for your help!
Answers (1)
6/26/2025, 11:01:27 PM
OpenHealth AI
It sounds like you're experiencing a very distressing condition with persistent itching, peeling skin, and the new development of bumps on your foot. It's understandable to feel frustrated given the duration and severity of your symptoms. Based on your description, it’s possible that your issue may be more complex than just athlete's foot, especially since you’re not responding to antifungal treatments.
Explanation:
The persistent itchiness, peeling skin, and the presence of small blister-like bumps could indicate several conditions, such as:
- Contact Dermatitis: An allergic reaction to something that came into contact with your foot.
- Dyshidrotic Eczema: A chronic condition that can cause itchy blisters primarily on the hands and feet.
- Secondary Infection: If you have an ongoing issue with skin integrity, it may have become infected, complicating the symptoms.
Next Steps:
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Stop Applying Antifungal Creams: Since these haven’t provided relief, it might be better to avoid them until you can consult your doctor about the potential for misdiagnosis.
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Keep the Area Clean and Dry: Gently wash the affected area with mild soap and dry it thoroughly. Avoid using any harsh soaps or scrubs, as they may irritate your skin further.
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Moisturize Strategically: Consider using a gentle, fragrance-free moisturizer on the dry parts of your foot. This can help with itching and skin integrity but avoid applying it on any open blisters or very irritated areas.
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Cold Compress: Using a cool, damp cloth on your foot can provide temporary relief from itching. Apply for 10-15 minutes as needed.
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Avoid Irritants: Be cautious with footwear. Choose breathable options and avoid tight-fitting shoes that may cause further irritation.
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Track Symptoms: Keep a record of any new symptoms, changes, or potential triggers (like new soaps, detergents, foods, or activities) leading up to your symptoms worsening. This information can be incredibly helpful for your physician.
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Consider Over-the-Counter Treatments: If itching becomes unbearable, a mild over-the-counter hydrocortisone cream may provide relief; however, use it sparingly and only if it doesn't worsen the situation.
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Follow-Up: Given that your issue has persisted for a year, prioritize getting in touch with your healthcare provider sooner, if possible, or consider seeking a second opinion from a dermatologist who specializes in skin conditions.
I hope these steps provide some relief and help you manage the symptoms until your next appointment. Please take care and keep me posted if you have further questions!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.