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Why am I finding small purple bruises on my forearms? DR ELLIE CANNON answers your questions

From every now and then I find small purple bruises on my forearms for no reason. They usually fade after a few days and I am otherwise fit and healthy. Should I bother my doctor with it?

Yes absolutely. Any unusual changes to your body should be discussed with your doctor. More often than not, the symptoms won’t indicate anything sinister, but if it’s something serious, the chances of an effective treatment and cure are always higher when a problem is discovered early.

Bruising usually occurs when blood vessels become damaged from injury, causing small bleeding under the skin. Special chemicals in the blood called clotting factors cause the blood to clot, which prevents a bruise from expanding too much. If you bruise more or less for no reason, this could indicate a problem with your blood’s ability to clot.

Many older people are more prone to bruising as a normal part of the aging process – the skin thins as we age, it is less protective, and the blood vessels underneath are more likely to be damaged by even the slightest bump.

Bruising usually occurs when blood vessels become damaged from injury, causing small bleeding under the skin

Bruising usually occurs when blood vessels become damaged from injury, causing small bleeding under the skin

Bruising can also be a side effect of many medications, especially aspirin and nonsteroidal anti-inflammatories.

But bruising can be a sign of a platelet problem, which is why tests are important. A low platelet count can be caused for a variety of reasons – from blood diseases such as thrombocytopenia to cancers such as leukemia or myeloma.

Blood tests are also important to check for liver and kidney disease, which can also affect how the blood clots.

An emergency appointment is important, despite the pandemic.

My feet really hurt, but I can’t make an appointment

Why can’t I get podiatry for my corns now that service has resumed on the NHS?

I have received many letters about the lack of podiatry appointments currently available since the lockdown easing.

Early in the outbreak, all routine appointments were discontinued due to social distance, and many NHS employees were transferred elsewhere.

Since appointments have started again, only the most serious and urgent cases are likely to be seen first.

For podiatry, this would be diabetic foot treatment rather than corns and calluses, which may still be on hold.

There will be a huge backlog after four months without service, and this is causing the delays.

Diabetes can cause irreversible damage to feet, including amputation, so these patients are given priority over corns and verrucas for the time being.

I’ve developed an uncomfortable crawling sensation in my groin and while I can’t see anything, I wonder if I have pinworms, as I had a persistent attack three years ago. I am not sexually active, but I am afraid this is something I could pass on.

Pinworms are small parasitic worms that often infect the intestines of children and spread easily. They look like 1 cm long strands of white cotton thread and can cause intense itching of the buttocks, especially at night.

Medication called mebendazole is usually very successful and can be bought without a prescription, but sometimes a second dose is required two weeks later.

But this doesn’t sound like pinworms. Another parasitic infection such as scabies, which is not necessarily sexually transmitted, should be considered.

Scabies, a type of mite, also causes intense itching, more often in the lower abdomen and groin, as well as in the hands, feet, and insides of the elbows.

A doctor can prescribe the right medicine for this, either an insecticide cream or a solution.

It is also normal for you to feel very itchy without any contamination. I have had many patients describe an unpleasant creepy crawling feeling when there was nothing at all.

This can happen after something like scabies, when that uncomfortable feeling persists. In this case, I would recommend a drug that controls itching, such as an antihistamine.

Itchiness can also become psychic and persistent due to what we call the ‘itch scratch cycle’: you itch because you are scratching and this repeats. Again, this can be treated with long-term itch control medications.

Itching can also be aggravated by harsh toiletries, so I would advise using only gentle, specially formulated products for the area.

I have experienced an incredibly painful sciatica that has worsened, resulting in throbbing, pinpricks, and numbness in my big toe. I also find it hard to get out because my legs hurt as soon as I start walking.

This doesn’t sound like sciatica, which is usually lower back pain that runs down the leg, usually on one side, but it could be both.

It is caused by pressure on the sciatic nerve and can cause pain, tingling, numbness or even weakness.

DO YOU HAVE A QUESTION FOR DR. ELLIE?

Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

Dr. Ellie can only answer in a general context and cannot respond to individual cases or provide personal answers.

Always consult your own doctor in case of health problems.

Usually these changes in feeling are in the back of the leg. It is also more common for the smaller toes to be affected when the problem spreads to the foot. It is not normal for sciatica to cause such specific big toe symptoms.

You also say that your leg swells and hurts after you walk.

This sounds more like the symptoms of a vascular problem in the leg. Leg swelling can be caused simply by lack of movement or weakness, as fluid builds up with the leg.

But it can also be a sign of problems in the veins of the leg, including a blood clot.

Pain while walking can also be a sign of a separate problem known as intermittent claudication. This happens because of a problem with the arteries rather than the veins that causes pain every time you walk – usually the pain stops when you stop and rest.

It could also be a sign of peripheral arterial disease, which occurs when your arteries narrow. You must urgently see your doctor for further examination.

Life would be harder in a Zero Covid UK

Zero-Covid – or almost completely eliminating Covid-19 from the UK, with barely detectable cases – is the strategy Boris Johnson must follow if we have any chance of defeating the pandemic. That said the All Party Parliamentary Group on Coronavirus last week.

And it may sound desirable … but not only is it a very unrealistic approach, it is also harmful when you consider what we would have to sacrifice to achieve it.

It would bring tougher, more frequent lockdowns, the destruction of the economy, more delays in vital cancer treatment, less access to health care and crushing uncertainty for all Britons.

It is also a pointless goal. We’ve never gotten to zero measles or tuberculosis, despite successful vaccinations – and we can handle the few cases that occur every year just fine.

There is nothing to suggest that Covid-19 would not follow the same manageable path. We need to lose the meaningless buzz words and focus on accepting our new reality. It is the most realistic and healthiest option.

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