Venous eczema occurs as a result of venous hypertension causing fluid to collect in the tissues. The stasis of this fluid in the soft tissues results in activation of the innate immune response and subsequent inflammation. Venous eczema has the following clinical characteristics: · Itchy red, blistered and crusted plaques ; or dry fissured and scaly plaques on one or both lower legs (commonly mistaken for cellulitis) · Atrophie Blanche (white irregular scars surrounded by red spots) · Orange-brown patches pigmentation due to haemosiderin deposition · Lipodermatosclerosis If you’re not sure if the patient has venous eczema, ask “Is it itchy?” Varicose eczema is often intensely pruritic and this is a common indication for intervention.
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