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Why are my lower legs itchy, with red swollen spots on them?

I'm a 40-year old woman who eats mostly home-made, unprocessed foods. The itchiness and red spots, about the size of a quarter and only on my lower legs, started about 6 months ago, out of the blue. I didn't change any of my normal habits. Since this began, I completely cut out wheat and sugar, but that didn't help. I have a used a shower filter (I change it every 6 months), scent-free laundry detergent, and no harsh chemical cleaners in my house for years. The itching is sometimes so bad I can't sleep at night. What can I do?
One possibility is that you have eczema. Eczema is an inflammatory condition of the skin characterized by dryness, redness, and itching. It is generally worse in winter months (as the cold dry air dries out the skin even more). It can generally be controlled through the use of a good skin moisturizer, preferably something thick and greasy like hydrolated petrolatum, which will trap in the skin's moisture better than a standard lotion, as well as using an over the counter steroid cream. Another possibility would be psoriasis, which is an autoimmune condition of the skin. Unlike eczema, the red spots in psoriasis tend to be more demarcated and brighter red, and they are typically covered with a very distinctive whitish or silvery scale. Sometimes psoriasis causes other problems as well, such as pitting of the nails and joint pain or swelling. The skin part of psoriasis can be treated with steroid creams, usually prescribed by a dermatologist or primary care doctor. If the spots on your legs are more nodular feeling and deeper and painful, then this could be a rare problem called erythema nodosum, which can be associated with other underlying medical problems. I suggest talking to your primary care doctor, who should be able to diagnose and treat this for you.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.

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