I sent this photo of my actual feet and ankles to Dr. Prabaharan (PCP), asking for his medical opinion. I didn’t say that I thought it was flea bites, but asked him if he thought I should see a podiatrist or dermatologist. Here’s what he responded to me:
Hi,
Discussed with the dermatologist.
See full recommendations below.
I have sent the medications to the pharmacy.
Let me know if you have any questions.
Favor dermatitis, less likely tinea given ankles and dorsal feet primarily involved
My recommendations are:
– recommend treat for both possible fungus and inflammatory condition together
– start over the counter terbinafine 1% cream twice daily to affected areas on ankles, top of feet, in between toes, and soles of feet
– Start triamcinolone 0.1% ointment twice daily to affected areas of rash for 4-6 weeks as needed in addition to moisturizers twice daily with Vaseline or CeraVe cream.
– For itch, can start a daily Claritin, Zyrtec, or Allegra. If any difficulty sleeping due to itch, you can take Benadryl; alternately could also take another Claritin, Zyrtec, or Allegra at night.
Please follow principles of gentle skin care. This includes the use of warm showers instead of hot showers (and minimize your shower length). I recommend Dove sensitive skin bar soap as other soaps can be drying and worsen your rash. After showering, please pat dry and apply a moisturizer such as CeraVe cream on the body. I also recommend that you stop using fabric softener (if you currently use it) and make sure your clothing detergent is one free of dyes and perfumes, such as All Free & Clear.
If the condition has not improved or gets worse, the patient should contact you or be re-evaluated in 6 weeks
Sincerely,
Velummylum Prabaharan, MD FACP
