What is an ankle rash? An ankle rash is an inflammatory reaction of the skin on the ankles. Rashes on the ankle can be caused by a wide variety of mild to serious diseases, disorders and conditions. Ankle rashes can affect a small to large area of one or both ankles at a time, and can occur in all age groups and populations. Ankle rashes are often part of larger areas of rash extending to the legs and feet. Ankle rashes vary greatly in appearance, extent and severity depending on the underlying cause. Ankle rashes may or may not be itchy and can be red, white, purple or silver in color. The texture of an ankle rash can be flat, raised, bumpy or scaly and include flaking off or peeling of skin cells. Ankle rashes can also appear as dots, spots or patches, or they may appear to be solid and continuous. An ankle rash can be a sign of a relatively minor condition, such as irritant contact dermatitis caused by exposure to poison ivy or poison oak. A rash on the ankles can also be caused by an allergic reaction to a variety of allergens (allergic contact dermatitis), such as grass. Other causes of ankle rashes include viral infections, autoimmune disorders, and varicose veins. Ankle rashes, along with leg and foot rashes, are also a complication of poorly managed diabetes and peripheral artery disease, which can cause skin changes due to poor blood flow to the extremities. Ankle rashes can have several serious causes. A rash of purple spots on the ankles or other areas can be caused by a potentially serious condition, such as allergic purpura.Any rash that is associated with allergies combined with shortness of breath, wheezing, or swelling of the face, mouth or throat is a symptom of a serious, potentially life-threatening allergic reaction called anaphylaxis. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms. Seek prompt medical care if you do not have life-threatening symptoms but your ankle rash is getting worse, the rash does not improve within a few days, or you develop other symptoms. What other symptoms might occur with an ankle rash? An ankle rash can occur by itself or with other symptoms that affect the skin and possibly other areas of the body. Symptoms vary depending on the underlying disease, disorder or condition. For example, you may have flu-like symptoms if the ankle rash is due to infection or inflammation. Some coexisting symptoms, such as anxiety and irritability, may be due to the underlying condition, or they may be caused by constant itching and scratching. Skin symptoms that may occur with an ankle rash An ankle rash may occur with other skin-related symptoms including: Accompanying rash on the legs or feet Bleeding (from broken skin) Blistering and possibly oozing of discharge from the rash or surrounding skin Burning or pain Change in skin texture Cracked skin Dry skin Itching Redness, irritation or inflammation Scaling, flaking or peeling skin Skin that is unusually cold to the touch (possibly a sign of peripheral artery disease) Swelling or puffiness around the rash Other symptoms that may occur with an ankle rash In some cases, an ankle rash may occur with symptoms that are related to other areas of the body. Symptoms may include: Decreased appetite Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains) Irritability in infants and children Joint pain or achiness and swelling Numbness in the lower legs and feet Red eyes Sneezing and runny nose Stress, anxiety or depression Symptoms of poor blood flow to the extremities (sores that do not heal, cold extremities, and muscle cramping) Unexplained weight loss Vomiting Symptoms that might indicate a serious or life-threatening condition In some cases, an ankle rash may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms: Change in level of consciousness or alertness, such as lethargy, passing out, or unresponsiveness Chest pain, pressure or tightness Rapid pulse Severe difficulty breathing, wheezing, or shortness of breath Severe headache or abdominal pain Sudden onset of bloody stools or urine that is bloody, red or pink Sudden swelling of the mouth, lips, tongue, face or throat Vomiting blood What causes an ankle rash? Ankle rashes can be caused by a wide variety of diseases, disorders and conditions, such as infection, inflammation, allergic reaction, parasite and insect bites, and autoimmune processes. For example, an acute ankle rash that appears suddenly may be caused by an allergic reaction or sensitivity to a particular substance, such as poison ivy, hair waxing or shaving, or an insect bite. A chronic, ongoing ankle rash may be caused by atopic dermatitis (eczema)or psoriasis. Psoriasis is characterized by slightly raised patches of itchy skin with red borders and silver scales. Serious causes of ankle rashes include a severe allergic reaction called anaphylaxis (tightening and closing of the airways), and cellulitis (an invasive bacterial or fungal infection of the skin and surrounding tissues). Infectious causes of an ankle rash An ankle rash may be caused by a variety of infectious diseases including: Bacterial infection, such as from streptococcal and staphylococcal bacteria Chickenpox Fifth disease (mild viral infection in children that can also cause harm to unborn babies) Folliculitis (infection or inflammation of a hair follicle) Measles Ringworm Rocky Mountain spotted fever Viral infections such as roseola Allergic causes of an ankle rash An ankle rash may be caused by an allergic reaction including: Allergic contact dermatitis, such as an allergy to a perfumed body lotion Allergic purpura Atopic dermatitis (eczema including chronic eczema) Drug reaction Irritant contact dermatitis, such as from contact with poison ivy, poison oak, or poison sumac Autoimmune and inflammatory causes of an ankle rash An ankle rash may be caused by autoimmune and inflammatory disorders including: Cutaneous lupus (autoimmune disease that affects the skin) Discoid eczema (often due to dry skin) Erythema nodosum (inflammatory disorder) Psoriasis Vasculitis (inflammation of blood vessels) Parasite or insect causes of an ankle rash An ankle rash may be caused by parasites or insects including: Bedbugs Body lice Fleas or ticks (ticks carry the bacteria that cause Rocky Mountain spotted fever) Mites (parasites that cause scabies) Mosquitoes (mosquitoes also carry parasitic diseases) Other causes of an ankle rash An ankle rash may also accompany the following conditions: Anxiety and stress Golfer’s vasculitis (lower leg rash caused by long periods of exercise in hot temperatures) Heat (heat rash) Methamphetamine abuse Varicose veins Venous eczema (also called gravitational dermatitis; a complication of deep vein thrombosis or other blood vessel disorder) Life-threatening causes of an ankle rash In some cases, an ankle rash may accompany a serious or life-threatening condition, including a severe allergic reaction called anaphylaxis. Life-threatening conditions include: Anaphylaxis Erythema multiforme (type of allergic reaction) Toxic epidermal necrolysis (skin and mucosal loss due to a severe medication reaction) What are the potential complications of an ankle rash? In some cases, an ankle rash can lead to complications, especially if there is severe itching and scratching that leads to breakdown of the skin. Scratching can introduce bacteria or fungi into the layers of skin, resulting in infections. Complications of an ankle rash include: Bacterial or fungal infection of the skin Cellulitis Open sores and lesions Permanent change in skin texture or scarring Permanent skin discoloration Complications of underlying causes of an ankle rash, such as diabetes or peripheral artery disease, can also occur. You can best reduce the risk of complications of an ankle rash and its underlying causes by following the treatment plan you and your healthcare provider develop specifically for you.