DR ELLIE CANNON: Is painful mottled skin on my thighs and groin sign of a serious problem?

A while ago I noticed patches of mottled skin on my thighs. I called my GP, who said not to worry. In the last two weeks they have spread to my groin and I have also developed pain in the area. I spoke to the practice nurse, who said there are signs of reduced blood flow to the legs. What could be causing the problem?

In some cases, mottled skin is normal and not harmful. For example, it can appear in the legs of babies and young people in cold weather, but disappears once they move into a warmer environment.

However, it is not normal if it appears on the abdomen or around the genitals in someone who has not had it before. It requires further examination by a doctor.

If the rash is there all the time and doesn’t go away in warmer temperatures, there’s probably a potentially serious underlying reason.

Doctors often associate this rash with an autoimmune disease that affects the blood vessels and circulation. Such conditions include lupus, or more commonly a disease called antiphospholipid syndrome.

Both diseases cause small blood clots to form in the blood vessels under the skin, creating a red pattern that appears as a rash.

GPs can detect these conditions using blood tests, as well as more common autoimmune problems such as rheumatoid arthritis. Doctors would also likely screen for blood clotting abnormalities.

Many GPs send photos of rashes to the local dermatology service for prompt expert advice. It may be worth asking to move things forward.

I have a serious vitamin D deficiency and two weeks ago my GP prescribed a six week course of colecalciferol. But I have noticed that my left ankle is a bit slower later in the day – are these problems related? I am 83 and have a heart condition, so I suffer from age related ailments.

Vitamin D has a number of important functions. One of its most important roles is to help bones absorb calcium properly, making them strong and hard, and to strengthen muscles and teeth.

Studies show that many elderly people in the UK are deficient in vitamin D. Our main source of it is sunshine. So if people don’t get out often because of vulnerability, they risk not getting enough.

We do get some vitamin D through our diet, but only a small amount through foods such as egg yolks and oily fish.

If you take more vitamin D than you need, too much calcium can build up in the body. This can damage the bones, kidneys and heart.

But an overdose would only happen if you had been taking vitamin D for a long time. I suspect six weeks is too short for that.

A stiff or sluggish ankle is more commonly caused by other health conditions. The ankle, like all joints, can be affected by osteoarthritis and other forms of arthritis, such as gout. But vitamin D deficiency can make bone and joint pain worse. Swollen ankles can also cause the joint to move slowly.

Swelling in this area is common in the elderly for many reasons – from heart problems to a lack of exercise, which can cause fluid to build up. Ankle swelling can also be a common side effect of medications such as the blood pressure pill amlodipine.

I’ve had a bad headache for the past few months. They tend to come on at the end of the day, but the pain lingers for up to a week. I am nearsighted and wear glasses most days. I recently moved offices to a space where it’s airy and stuffy, but could the headache be caused by something serious?

Headaches are very common and are rarely a sign of anything serious. That said, it’s always important to look out for other symptoms associated with a headache.

If a headache comes on at the end of the day – after a full day at the office – it may indicate that the problem is related to the environment. Another sign of this is if headaches don’t appear on weekends or holidays.

There are ways to reduce eye strain, such as taking frequent screen breaks and wearing special lenses.

It is not uncommon for people to experience certain symptoms when they are in a certain place, but not elsewhere. Experts call this phenomenon “sick building syndrome.” A combination of lack of ventilation, uncomfortable temperatures and stress would be the reason.

It is especially common in open office spaces with poor ventilation, bright light and a lot of dust. This type of health issue is your employer’s responsibility – and you should speak to a manager about it.

Sick Building Syndrome is usually associated with tension headaches, which feel like a constant ache on both sides, and can be contracted by anyone who is stressed, dehydrated, eats irregularly, or has poor posture when sitting at a desk.

The Archbishop’s honesty about depression is a blessing

In a Good Friday sermon, the Archbishop of Canterbury, Justin Welby, pictured above, spoke about his mental health and revealed that taking anti-depressants helps him feel ‘like an average person’.

Referring to the sourpuss ass in AA Milne’s Winnie-The-Pooh, he added that the pills “give me back the status of Eeyore from something far worse.”

I know from speaking publicly about my own use of antidepressants—which I take for anxiety—that people are surprised that doctors are faced with such normal problems. Likewise, some might assume that an archbishop is immune to these daily challenges. Of course we are not.

Some people say that no one needs to take antidepressants and that such mental illnesses can be addressed with life improvements. But thankfully, a confession like that of the Archbishop – from one so adept at prayer and philosophy and whose life is devoted to higher forms of thought – shatters that illusion.

Do bowel tests… and stay alert

Last month I wrote about the importance of colon cancer screening and reminded all of you to get your tests if you had one.

I was prompted to do this after reading that a third of people have no qualms about it. The tests are sent to 56 to 74 year olds every two years in England, but readers have written stories of loved ones who were diagnosed with bowel cancer despite a negative test.

While the tests are very accurate, they are not 100 percent foolproof. Screening is only one part of detecting colon cancer early. The other monitors changes in bowel movements and seeks help if something is wrong.

If there is blood in the toilet, bloating, or a change in toilet activity, see your doctor. Don’t assume everything is fine after a negative screening test.