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Dermatitis, or inflammation of the skin in the lower legs and feet may be caused by a number of acute and chronic skin conditions. Acute dermatitis is characterized by red and swollen and blisters while chronic dermatitis is accompanied by darkened and thickened skin (plaques) that result from constant rubbing and scratching. Here are some of the common causes:

Atopic Dermatitis. One of the most common causes of rashes in the lower legs and feet is atopic dermatitis, a type of eczema that is typically affects the feet and ankles of infants, behind the knees of older children and adults. Acute flares of atopic dermatitis consist of inflamed, red, skin with blisters and weepy patches, while chronic eczema is marked by dry, itchy, and thickened skin. Sometimes the skin becomes infected due to scratching.

Contact dermatitis. This is another type of eczema that develops due to contact with irritants, such as tight socks or soaps, but it may also develop due to a specific allergic reaction. Certain skin products and cosmetics containing fragrances, preservatives, and topical antibiotics are more likely to sensitize the skin of the lower leg than other sites, although the reason for this is unclear. It results in blistering eruptions, itching and scaling.

Lichen Simplex. Prolonged rubbing and scratching causes thickening of the skin on the lower limbs. It appears as an isolated area of lichenified dermatitis, but multiple plaques may also develop. This condition is also called neurodermatitis, because the itch appears to be caused by sensitive nerve fibers following nerve injury. It is characterized by dry, scaly skin with leathery consistency, dark pigmentation, scratch marks and broken hairs.

Discoid eczema. This type of eczema is also called nummular dermatitis, which appears as round and oval plaques. It is often triggered by an insect bite, a cut, or an injury to the skin, and may be infected bacteria. It may start with a single patch on one leg, followed by multiple lesions that appear on the lower legs, trunk and arms. Dry discoid eczema is often due to over-dry skin that is not itchy, while 'wet' discoid eczema is characterized by fluid leaking from the skin.

Gravitational dermatitis. This skin disorder is caused by poor blood flow through the veins in the leg, which may be due to age-related damage in the valves of the veins, blood clot formation, or deep skin infection (cellulitis). Prolonged standing and hot weather causes pooling of blood in the ankles and feet, resulting in chronic swelling. Dermatitis appears as patches, but in some people, the skin around the ankle may be affected. The skin becomes red, itchy, scaly, crusty and cracked. The skin may also be discolored from blood cells leaking from the blood vessels.

Psoriasis. This is a group of chronic conditions that affect about two percent of the population. It may present as small to large plaques of skin that is red, well demarcated, with silvery scales. It usually affects the lower back, elbows, knees, and shins, but it may arise on any part of the body. Some people with psoriasis also develop psoriatic arthritis, which is characterized by pain in one or more joints.

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