Starting months ago, my husband developed red circles on his lower body. First they diagnosed it as ringworm. He had a biopsy done on one of them, and they diagnosed it as "Schamberg." I cannot find any information about this. The doctor states it's nothing and we should just keep putting cream on it. My husband's legs are a mess because of these ringlike blood circles. We have not changed any detergents or medicines, so it's not an allergy. Please help with any information you may have on this diagnosis.

Cathy

Though I know relatively little about this illness, I have decided to answer your question for two reasons. First, I can help you a little bit about the disease. Second, I want to comment on the approach patients should take if they are not happy with a physician's answer to a question.

Schamberg's disease has a variety of other names as well, including "pigmented purpuric dermatitis" and "chronic pigmented purpura." It is a rash usually seen in adults, usually involving the legs. The rash consists of purplish lesions. The cause of the illness is unknown, but it seems to be inflammatory in nature. Cases have been linked to a variety of medications, so if your husband is taking any medications, he and his doctor may want to consider discontinuing them, if possible. (Do not stop taking any medications without discussing the matter with a physician first, however.) One minor concern is that there are a few reports of such a rash either progressing to or being confused with mycosis fungoides, a form of lymphoma. At least some patients with Schamberg's disease respond to corticosteroids (anti-inflammatory drugs) and anti-allergy medications.

Now, what should you do if you are not happy with an answer that a physician gives? First, try to avoid sounding confrontational or antagonistic. Many doctors (and most non-doctors, for that matter) can become defensive in such situations and be less likely to help explain the problem any further. What I suggest is to ask something like, "Do you know where I can get more information on Schamberg's disease?" Or, "Is there a specialist I can see or speak to regarding this diagnosis?" If this approach does not help, you always have the option of seeing another physician. Some people on HMOs fear that their insurer will not let them get another doctor. While that may be true for specialists, you can almost always change primary physicians quite easily.