Your Health Questions Answered

STEROIDS ANXIETY

I developed a pin-prick rash on my arms and legs, which spread quickly over two days. I was also bleeding from my gums, and had blood in my stools. I had a blood test, which showed that my platelet count was low. I have been told that I have ITP. No one knows the cause. I have been given steroids, which has improved the rash, but I'm told that my blood is still abnormal. Will I need to stay on steroids for ever?

I stands for idiopathic, which means that no one knows what has caused it. T stands for thrombocytopaenic, which means that you have too few platelets, the tiny blood cells that prevent bleeding, so you will bruise easily and bleed spontaneously. P is for purpura, a pin-prick, purplish rash caused by the leakage of tiny amounts of blood into the skin. Your rash and bleeding have been caused by too few platelets - no one knows why. Most people who develop ITP have antibodies that their body has produced against their platelets and that attach themselves to them. Steroids suppress these antibodies, and this helps the platelet count to recover. ITP can stop spontaneously, but it can also become chronic. It is more common in women than in men. You may need to take steroids for a long time, but there are other treatments, including removal of the spleen, which destroys platelets.

CORN PROBLEMS

I have had a corn in the middle of my foot, near the ball, for 10 years. Is there surgery that gets rid of these? When I have tried corn plasters with acid on them, I find them painful and have to take it off after a day. Can I remove them?

A corn is a collection of dry, hard skin that forms as a pressure point. The skin thickens and hardens to protect the underlying area. The centre of the corn contains a core of dead cells. Corns tend to develop on the tops and sides of toes. If you can remove the pressure that is causing a corn, it may disappear. If it is near the ball of your foot, tight-fitting shoes or high heels may be putting excessive pressure on the ball of the foot. If you have bunions or hammer toes, these can provoke corn formation. See a podiatrist. Corns can be removed, or partially removed, with a scalpel. But if you don't remove the underlying cause, they will persist.

Please send your questions and suggestions to A Question of Health, 'The Independent', 191 Marsh Wall, London E14 9RS; fax 020-7005 2182, e-mail health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions.

Readers write

An explanation for a painful swollen finger, from CB: I've had the same symptoms, but it was diagnosed as palindromic rheumatism, causing inflammation lasting 24-36 hours. I first had it at 34 for two years and it turned into rheumatoid arthritis for 23 years. Post-menopause, this retreated, and the palindromic attacks returned. They can be triggered by red wine and red meat.