Harry: Well, what we need to know is what is the nature of this scaly rash that you've got around the ankles. Is it only on the ankles and nowhere else on your body?

Jonathan: It's only on my ankles.

Harry: And how long have you had this?

Jonathan: Probably for about eight months now.

Harry: Is it itchy?

Jonathan: Yes, it's very itchy.

Harry: It sounds like you've got eczema but you need to have that confirmed because there are many other possibilities.

Jonathan: What is this eczema caused by?

Harry: It can be caused by a number of things, but usually in that part of the body it would be something that your ankles are exposed to. For example, it may be the socks that you are wearing or other clothing that you are wearing. It may be the soap that you are using. It may be some body ointment that you are smearing on yourself and, for some or other reason, it may involve mainly the ankles. It may be certain boots that you are using - you may be a hiker and your hiking boots may be the cause. So, in the first instance, you have to try to find out if this eczema is occurring in response to some environmental trigger or allergen. Eczema is basically a chronic, recurrent allergic condition of the skin. And the way you do that is to make an appointment of at least half an hour with your GP and he must take a good history along the lines that I've mentioned to try to pick up what might be the environmental trigger. And then he must examine your ankles to confirm that it is eczema. If he's not sure, he must send you to a dermatologist to confirm the diagnosis.

Jonathan: I'd just like to add something here - in 1994 I had a varicose vein operation.

Harry: Now there you are, that is a possibility.

Jonathan: Can that be the cause?

Harry: Absolutely. You might have what is called varicose eczema, which is an eczema that is actually secondary to the stagnation of the blood. When you've got varicose veins, the blood is not flowing smoothly and fast through the veins and very commonly that produces what we call a varicose eczema, which then goes on to form an ulcer. And you need to diagnose that sooner rather than later because if you get an ulcer it often becomes chronic and becomes a very difficult thing to treat. So a doctor must see you because during his examination he will not only look at the skin, he will also check out your veins. And if you have got this varicose eczema then obviously the treatment must be directed towards the correction of the varicose veins.

Jonathan: Well, I went to the doctor and he put me on these antibiotics.

Harry: No, wait a minute. The antibiotics can only be a treatment for a complication. In other words, you might have varicose eczema that is complicated by infection. So the antibiotics will only treat the complication, but the underlying problem will still remain - namely the varicose veins. And that has got to be treated if you are to prevent the condition from getting worse or recurring.

Jonathan: Okay, thank you very much.