Schamberg’s disease
Introduction
Schamberg’s disease is characterized by sudden appearance of dark spots over the skin.
The most common site affected is the lower half of the leg, and rarely appears in the thighs, buttocks, trunk or arms.
It is usually benign (does not spread to other areas) and chronic (slowly developing) in nature.
Epidemiology
a) It is commonly seen in people who are aged 40-50years or above; &
b) Especially those who are involved in long hours of standing jobs such as security guards, traffic police, teachers, cooks, salespersons etc.
c) It commonly affects males.
It is more commonly seen in families, who have a history of varicose veins.
It can also occur as a side effect of the following drugs:-
• Painkillers
• Anti-hypertensive
• Diuretics
• Anti diabetic medicines
Cause
It is caused due to stasis of the blood within the veins (slowing or stoppage in blood flow), followed by gradual leakage of blood from the veins.
The blood contains RBCs (Red Blood Cells) which gets deposited into the skin. The RBC then breaks down and releases a dark pigment called Hemosiderin, which is responsible for the darkening of the skin.
Appearance
Initially it appears as a orange/red rash, like those in mosquito bites (due to initial deposition of RBCs in the skin). Gradually it develops into dark spots (due to Hemosiderin).
Symptoms
It is usually asymptomatic, and there is no pain or itching. But occasionally it can be slightly itchy.
Treatment
If you’re suffering from such condition, consult your nearest dermatologist for proper treatment of this disease. It is advisable to bring your past medication history, as it helps in further diagnosis and prescription.
Now, there are certain oral medications that are prescribed, but they are not 100% effective i.e. there is no guaranteed cure for this condition. Multiple medicines are under trial for treating this disease, with some of them proving to be effective in many patients as well.
• Oral medications:-
a. Pentoxyfylline
b. Oral vitamin C
c. Rutoside
• Topical creams:-
a. De-pigmenting creams, for lightening the skin; &
b. In case of itching, antihistaminic creams such as Cetrizine, Levocetrizine or steroids etc. can be prescribed.
The patient has to understand that there is no instant or rapid cure for this condition, treatment and cure takes time.
More importantly, the patient has to do some lifestyle modifications, which help in curing and prevention of this condition.
Prevention
1. Avoid prolonged standing.
2. Try to keep your foot end elevated, for example: Keeping a pillow under your feet while sleeping.
3. Use elastic stockings or crepe bandage while standing for long duration.
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