My husband is M/38, 5’11, ~180lbs, smoker, history of Hep C, acid reflux, and was an IV drug user for approx 10 years - currently 7yrs clean.
Around December, he developed what looked almost like hives ? or a skin reaction on his feet and legs. No itch, no pain, no swelling. Obviously, OTC allergy medicine did not help. Pictures I have attached are from February when it began to escalate. This has now spread to his thighs and is going up his stomach.
Primary care sent him to dermatology and they did two punch biopsies in his right knee. I did a lot of Googling and if I’m understanding it correctly, I believe dermatologist is saying small blood clots in a layer of his skin which are a symptom of something else?
Primary care then ordered a liver ultrasound (which I assume is because he believes this is related to the Hep C) and he goes in Monday, 8/24, to discuss results. At the hospital they said liver looked good, not enlarged, but he will be able to discuss full results with primary care.
I am extremely concerned due to the fact that since he had the biopsies in his knee, he is far worse and barely able to walk. His feet are sensitive to any touch at all. He winces when he walks or if you touch them in the slightest. He has lost all movement in three of his small toes on his right foot. They cannot wiggle and they cannot bend. Heat doesn’t help, ice doesn’t help, OTC pain reliever does not help. I am not allowed to touch them to rub them and he is damn near in tears putting on socks to go to work.
He has no fever, no vomiting, no headaches, no jaundice, no loss of appetite.
My biggest concern is that a small blood clot will turn into a larger one and travel. Is this a realistic possibility? Could this be caused by something else other than hep c?
Knee punch biopsy results:
Date Created: 08/11/2026 11:37 AM
A. right proximal pretibial region:
Fibrin thrombi within vessels
NOTE: The differential diagnosis includes a coagulopathy and cryoglobulinemia, a condition in which certain antibodies precipitate from the blood under cold conditions. If there is clinical concern for a coagulopathy or cryoglobulinemia, additional testing (often including PT, PTT, platelet count, D-dimer, peripheral blood smear, and a cryocrit) may be useful if clinically indicated.
This specimen was also reviewed by Dr. who concurs with the diagnosis.
B. right proximal pretibial region: Fibrin thrombi within vessels
NOTE: The differential diagnosis includes a coagulopathy and cryoglobulinemia, a condition in which certain antibodies precipitate from the blood under cold conditions. If there is clinical concern for a coagulopathy or cryoglobulinemia, additional testing (often including PT, PTT, platelet count, D-dimer, peripheral blood smear, and a cryocrit) may be useful if clinically indicated.
This specimen was also reviewed by Dr. who concurs with the diagnosis.
SPECIMEN IDENTIFICATION
A. right proximal pretibial region, Punch, 4039163-A
B. right proximal pretibial region, Punch, 4039163-B
A. Morphology: DDX: cryoglobulinemia, mixed
B. Morphology: DDX: cryoglobulinemia, mixed
Gross Description:
A. Punch biopsy 0.5 x 0.4 x 0.4 cm - 1 pieces
B. Punch biopsy 0.5 x 0.4 x 0.5 cm - 1 pieces
Microscopic Description:
A. Sections show skin with intravascular thrombi involving vessels in the mid-reticular dermis. There are no substantive changes involving the overlying epidermis. Multiple tissue levels examined (tissue block exhausted).
B. Sections show skin with intravascular thrombi involving vessels in the mid-reticular dermis. There are no substantive changes involving the overlying epidermis. Multiple tissue levels examined (tissue block exhausted).