Skin rash on both ankles

Hi @stevemann and welcome to Mayo Clinic Connect. I can only imagine the frustration of going to the dermatologist only to walk away without answers.

Here a bit on information on ankle rashes. "What does a rash around your ankles mean? An ankle rash can be a sign of a relatively minor condition, such as irritant contact dermatitis caused by exposure to poison ivy or poison oak. A rash on the ankles can also be caused by an allergic reaction to a variety of allergens (allergic contact dermatitis), such as grass." --- https://www.healthgrades.com/right-care/skin-hair-and-nails/ankle-rash

Have you talked to your neuropathy doctor about these rashes? Sometime rashes are a result of the nerve damage from the neuropathy. Also, what topical cream do they have you using?

Started with BETAMETHASONE, now using Maputo in with zinc oxide. 2 weeks on the betamethosone and nothing changed. A week into the combo and some improvement seen. Biopsy came back inconclusive. Dermatologist doc “has to think about it.” I send my neurologist an email. Thanks for that!

Amanda provided helpful information about enviromental allergens. Does the rash itch? Normally contact dermatitis itches along with the pain. Truthfully with contact allergies most exibit small pimple like or blister like bumps or a red rash with contact allergies and not scaly and cracked skin. Contact allergies are extremely itchy. Yet one form of eczema with scaly, dry and cracked skin is Dyshidrotic Eczema, DE. DE normally manifests itself on the feet and hands. It is painful and for many it doesn't itch.
I have Allergic Contact Dermatis, ACD. I am allergic to many man made materials, elastic is one. Could you be wearing socks that fold at the ankle that have elastic in them? I am also allergic to adhesives, you mentioned bandaids. I get a rash from them. Could you try wrapping the ankles with cotton gauze and then putting paper tape over them to hold it together. Cottonique, on line, sells 100% cotton socks for men and women which are good quality. It takes getting used to socks without elastic yet for me it's a necessity because of chemicals and also natural elements coming from rubber used to make elastics or other blended materials. Another problem for me is the preservates and other ingredients in ointments. I'm even allergic to cortisone. You mentioned ointments, be sure to study for active and inactive ingredients for allergic reactions on the internet. The Bethametasone is corticosteroid which is a treament, it isn't solving what is causing your issues. In order for it not to reoccur you need to find out the cause.
I have gotten a red rash on my ankles from the boots I was wearing. My histamine level is high and as such any pressure can trigger a rash.
This may all to tied to neuropathy and not allergies, but if the neurologist can't determine a cause consider contact allergy testing, look up the 5 Day Extended Patch Test.
I understand being reluctant to show a photo, however, I deal with 3 forms of eczema, I was able to self diagnose one form of eczema which the doctors were treating incorrectly by seeing photo of this unique rash a member sent in on a different skin blogging site. A good source to check out skin rashes is dermnetnz.org. This is a fanastic website to help with diagnosis, it has the most complete list of skin diseases and the best photograph collection of all types of skin diseases I have come across.
Please don't hesitate to show a photo, it is helpful if you want others to identify what you are suffering with. With our afflictions we learn to be humble and grateful for help. Don't be ashamed, everyone of us on this site is dealing with health concerns and we are warriors, we aren't giving up, we keep trying to learn more to improve our health. I'm in good shape today because of sites like the Mayo and others. Doctors are necessary and helpful, but we still have to educate ourselves to know to ask the right questions.

Hi all. Thanks for all the great information which will give me more avenues to research. I saw my initial dermatologist today and she told me to continue as is which I’m not too happy about. I also saw my primary care physician who recommended a dermatologist in Boston specialist that he personally knew so I sent her the pictures of my ankles and the biopsy results.
The socks that I wear are all loose fitting socks for diabetic neuropathy there’s no elastic in them whatsoever and I went a week without wearing socks just flip-flops and now my feet are hurting from the flip-flops. Can’t win! Interesting that you mention histamine levels being that I had a problem years ago with histamine levels in that I had to take Zyrtec to make it go away. I also questioned my primary care doctor why my blood tests have not been done, if there was some kind of formulation change to the medication that I’m on from the manufacturer, and the oddity that it’s both ankles not just one.
I so agree with the statement that they’re treating the result not the cause!
Haven’t heard back from my neurologist yet, which is so typical of him, and will let you know when he does.
I decided to stop taking my cholesterol medication to see if that has any effect although it’s not a statin it’s zetia. I’ll give that a couple of weeks and see what happens.
Much thanks to everyone

Heard back from my neurologist and said skin rashes are not likely caused from neuropathy. My visit is today with a second dermatologist. Rash seems to be getting better but not much.

Have an update on my ankle rash. Saw another Dermatologist at bidmc and she was excellent. The diagnosis is…
“ combination of
stasis dermatitis/venous insufficiency (slowing down the wound
healing process) and contact dermatitis (photos sent in with
bright erythematous plaques) and traumatic lesions (reports
lesions worsened with rubbing and several lesions today at line”.
In English it’s a combination of my neuropathy, insufficient blood flow, rubbing, and maybe an allergic reaction to the ointments.she disagreed with my neurologist opinion that neuropathy has nothing to do with it.
Now using these DuoDerm pads on both ankles. After 2 days looks good. We’ll see after 5-7.
Hip replacement surgery is back on.

@stevemann You beat me to the punch! I was going to post to you and ask how things were going. How great you found a second dermatologist with more experience in your situation. So glad to hear her suggestions are working for you. I bet that is a big relief, right?

Will you come back and report after a few more days on this course of treatment, please?
Ginger

Hello all again,
I’ve been taking those pads on my ankles and they are completely healed skin is just a little bit crusty compared to the rest but it’s 100% better than it was.
Saw my surgeon for my hip replacement and he’s good to go. As a matter of fact I’m sitting in the hospital right now 12 hours out from my hip replacement so that is gone somewhat well last night wasn’t great but it’s better now and I saw my foot doctor and she told me just to ice it and it was from your gate walking funny and my foots fine so my ankles fine my foots fine and my hip is fine . Need to have a long talk with my neurologist as soon as I can walk reasonably or find a new one. Again thanks for all your help this website is the best thing I’ve ever done!