Author: Dr Ian Coulson, Dermatologist (2023)
Edited by the DermNet content department
This elderly lady has a rash affecting both lower legs. It is weepy and itchy. She has not responded to a week of oral antibiotics.
This is bilateral lower leg eczema, and it is often multifactorial. There is often underlying venous incompetence, compounded by both irritant or allergic contact dermatitis. It is often bilateral, which cellulitis is almost never!
Rest, elevation, potassium permanganate compresses or soaks, a topical steroid to suppress the eczema, and compression.
Doppler ankle brachial pressure index (ABPI) should be measured to assess the safety of high compression bandaging. Consideration should be given to what is being used topically, and patch testing is indicated to exclude an allergic contact dermatitis to a medicament dressing or bandage.
See: Venous eczema.
