Unexplained Blisters and Weakness in Legs: Possible Causes and Solutions

Q: Unexplained Blisters and Weakness in Legs: Possible Causes and Solutions

Hello： It is difficult to determine the issue based solely on this information. <br>I recommend separating the concerns of foot weakness and blisters. <br>For foot weakness, it is indeed advisable to consult a neurologist, preferably at a regional hospital or higher, as they can

Weakness in the feet accompanied by unexplained blisters?

Dear Dr.
Lin,
My mother is 58 years old.
Over the past six months, she has experienced weakness in her legs (mainly feeling unsteady while walking, as if she is walking on cotton).
In the last three months, she has developed unexplained blisters on the tops of her feet and calves (which have appeared gradually), and they are not itchy.
I took her to a neurologist for an examination, but the doctor indicated that the test results were normal and advised us to continue monitoring her condition.
Currently, the sensations of walking on cotton and the blisters persist, and I am quite confused.
Could you please advise on what might be the underlying issue and which specialty she should consult? Thank you.
Note: My mother has undergone heart stent surgery, and her regular check-ups show that all test results are within normal limits (including fasting blood sugar, basic liver function tests, cardiovascular risk assessments, and cholesterol levels).
She typically finishes her meals by 5:00 PM and does not eat afterward, and she drinks a 150ml cup of rice wine before bed to help her sleep.

Ms. Zhang, 30~39 year old female. Ask Date: 2022/04/03

Dr. Lin Wufu reply Internal Medicine

Hello: It is difficult to determine the issue based solely on this information.
I recommend separating the concerns of foot weakness and blisters.
For foot weakness, it is indeed advisable to consult a neurologist, preferably at a regional hospital or higher, as they can arrange for further neurological examinations.
For the blisters, you can initially see a dermatologist to confirm whether it is a simple skin issue.
If the dermatologist suspects it may be related to a systemic problem, they will assist in making a referral.
(It is recommended to see both the neurologist and dermatologist at the same hospital for easier information consolidation and communication.)

Reply Date: 2022/04/03

More Info

Unexplained blisters and weakness in the legs can be concerning symptoms, especially in a 58-year-old individual with a history of heart surgery. Given your mother's symptoms of leg weakness and the appearance of unexplained blisters, it is essential to consider several potential causes and appropriate next steps.

Possible Causes
1. Peripheral Neuropathy: The sensation of walking on cotton could indicate peripheral neuropathy, which is a condition resulting from damage to the peripheral nerves. This can lead to weakness, numbness, and tingling sensations. Diabetes, vitamin deficiencies (such as B12), and certain medications can contribute to this condition.

2. Dermatological Issues: The blisters on the legs could be related to a dermatological condition. Conditions such as bullous pemphigoid, which is an autoimmune blistering disorder, or contact dermatitis could cause blisters without itching. It would be beneficial to consult a dermatologist for a thorough examination.

3. Vascular Issues: Given your mother's history of heart disease, vascular problems could also be a concern. Poor circulation can lead to weakness in the legs and may also cause skin changes, including blisters. A vascular specialist could assess blood flow and circulation in the legs.

4. Medication Side Effects: If your mother is taking medications for her heart condition, it is important to review these with her physician. Some medications can cause side effects that include weakness and skin reactions.

5. Systemic Conditions: Conditions such as lupus or other autoimmune diseases can manifest with both skin symptoms and neurological symptoms. A rheumatologist could help evaluate for these systemic issues.

Recommended Next Steps
1. Consult a Dermatologist: Since the blisters are a prominent symptom, starting with a dermatologist could provide insights into the skin condition. They may perform a biopsy or other tests to determine the cause of the blisters.

2. Neurological Evaluation: Although a neurologist has already assessed your mother, it may be worthwhile to seek a second opinion or further testing, such as nerve conduction studies, to evaluate for peripheral neuropathy or other neurological conditions.

3. Vascular Assessment: A visit to a vascular specialist could help rule out any circulatory issues that may be contributing to her symptoms.

4. Review Medications: Ensure that all medications are reviewed by her primary care physician or a pharmacist to identify any potential side effects or interactions that could be causing her symptoms.

5. Lifestyle Modifications: Encourage your mother to maintain a balanced diet, stay hydrated, and engage in light physical activity as tolerated. This can help improve overall health and potentially alleviate some symptoms.

Conclusion
In summary, the combination of unexplained blisters and weakness in the legs warrants a comprehensive evaluation involving multiple specialties. Starting with a dermatologist for the skin symptoms and considering further neurological and vascular assessments will be crucial in determining the underlying cause. It is essential to keep an open line of communication with her healthcare providers and advocate for thorough investigations to ensure her health concerns are addressed appropriately.

Similar Q&A

Understanding Leg Weakness: Causes and Solutions for Office Workers

Hello Doctor: I am 30 years old and work in a sales position, but I do not have to attend social gatherings. I usually go to bed before midnight. My job often requires prolonged sitting. After taking a few months off from work, I returned to find that I frequently experience weak...

Dr. Wu Fangcan reply Family Medicine
According to your description: Is it possible that you are not getting enough sunlight, lacking exercise, or have an unbalanced diet with a deficiency in B vitamins? Or could it be Monday syndrome? Please consult a family medicine physician for evaluation and assessment. Thank yo...

Unexplained Leg Swelling and Pain: A Neurological Concern

Hello doctor, on the night of April 27th this year, I injured the bottom of my left foot on a plug, leaving a wound. I disinfected it and applied ointment, but the next evening, the top of my left foot suddenly swelled up like a hill. My right foot also swelled, but not as much a...

Dr. Jiang Junyi reply Neurology
Dear Ms. Jill, You mentioned that the discomfort was initially localized below the ankle, but it has now extended to the thigh and is painful to the bone. This upward progression of abnormal sensations may suggest chronic polyneuropathy. However, you also noted symptoms of edema...

Understanding Unknown Skin Blisters: Causes and Treatment Options

My mother is 50 years old and has developed a pus-filled blister on her foot. She has undergone surgery once but did not see any improvement. The blister contains a white, jelly-like substance that increases in quantity when it comes into contact with water. I am unsure what this...

Dr. Hong Zhengsheng reply Dermatology
Dear Mr. Lu, Based on the information you provided, it is currently not possible to determine a clear diagnosis. The most significant characteristic of skin diseases is that "seeing is believing and tactile examination is essential." It is indeed challenging to convey ...

Understanding Weakness in Hands and Feet: Causes and Solutions

Hello, I have been troubled by a long-standing issue where my hands and feet often feel weak. Sometimes, I even struggle to lift my hands to brush my teeth, and when I walk up stairs, it can get so severe that I end up kneeling down. I have low blood pressure and previously under...

Dr. Xiao Yongxun reply Internal Medicine
Hello, in response to your question. The complaint of "weakness in the limbs" is common in clinical practice; however, due to the subjective nature of the experience, which varies from person to person, and the multitude of potential causes that lack specificity, it can...