DEAR DR. DONOHUE: Yesterday I had a red blotch on my leg just above the ankle. It didn’t hurt. Today the redness has spread upward on my leg to the calf, and the skin is tender and feels warm. Would soaking it help? I live alone and have a hard time getting to a doctor. I don’t drive. — M.K.

ANSWER: I hope that you haven’t waited for a reply before you’ve sought a doctor’s advice. What you describe fits the picture of cellulitis, an infection of the skin and the tissues lying beneath the skin. The skin turns red, is hot to the touch and hurts. There’s swelling beneath the skin. The infection advances rapidly, so quick action is necessary. The infection can raise body temperature and make the person feel miserable.

The cause most often is due to the strep or staph germ. Germs enter the skin through tiny cracks, cuts, insect bites or a sliver that has penetrated the skin. You might not be aware of any of these skin breaches. They can be so minor that you don’t see them. Athlete’s foot, the common fungal infection, provides another opportunity for these germs to invade the skin. People whose ankles are chronically swollen are a target for cellulitis, as are those who have had a leg vein removed for bypass surgery.

Antibiotics cure the infection. The sooner they’re started, the better. Elevating the leg lessens swelling, but nothing is a substitute for an antibiotic. Soaking your leg will not help.

The word “cellulitis” is confused with “cellulite.” Cellulite is skin dimpling due to underlying fat. It is not an infection.

DEAR DR. DONOHUE: My right big toe turned red quite suddenly and hurt like heck. I didn’t injure it. My doctor gave me pain medicine that took away most of the pain, and the toe gradually got better.

He didn’t tell me what I had. Can you give me a name for this? — G.S.

ANSWER: You give a classic description of gout. It often strikes the big toe. The base of that toe becomes hot, red and painful, and all of this happens very quickly.

One gout attack generally is followed by another — not right away, but in the future. Stay away from organ meats like liver and sweetbreads. Cut way back on alcohol, or stop completely. Beer is liable to set off an attack. Increase your intake of low-fat dairy products. They prevent a recurrence.

You can’t let this stay up in the air. You need your uric acid tested. Uric acid is the stuff that infiltrates joints and causes gout. If you do have another attack or if your uric acid is quite high, the doctor will put you on medicines that slow the production of uric acid or increase its passage into the urine.

The booklet on gout explains this illness and its treatment. Readers can order a copy by writing: Dr. Donohue — No. 302, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: This summer, I’m taking my family for a two-week vacation in the mountains.

I take blood pressure medicine. Since I started on the drug, my pressures have been good. Will the elevation of the mountains cause my pressure to rise? — W.W.

ANSWER: Altitude has little effect on blood pressure. It does have an effect on people whose hearts have been weakened by high blood pressure. If your heart is healthy, you should not have any problems.

All the same, if your destination is higher than 8,000 feet (2,500 meters), ascend in stages. Spend one night at a lower level. Don’t overdo things in the first few days at such elevations.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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