Eczema on your legs might be caused by venous insufficiency
Stasis dermatitis is an eczematous eruption that occurs on the lower legs in some patients with chronic venous insufficiency. In early stages, it presents itself as a dry rash on the lower legs that gets worse with scratching. Over time, it progresses to broad areas of redness and scaling, eventually leading to significant skin atrophy and/or ulceration. Ultimately, entire process is the end result of prolonged ambulatory venous hypertension.
Venous Ulcers and Arterial Ulcers
What may be obvious to some is not always clear to others, even for people within the medical profession. It is even more difficult for the average patient to say what is or is not a venous leg ulcer.
To diagnose venous origin of an ulcer, we need to demonstrate presence of venous incompetence and /or obstruction, hence a venous ulcer. On the other hand, an arterial ulcer is a result of severe deficit of arterial blood supply to an extremity, usually a result of severe atherosclerosis and PAD.
What if an ulcer is due to combined venous and arterial insufficiency?
In patients with chronic, long lasting or/and poorly controlled Diabetes mellitus, ulcers might represent compromised microcirculation and/or advanced peripheral neuropathy.
On rare occasions, a leg ulcer might represent a metastatic malignant lesion. Bedridden patients might develop pressure ulcers. Severe skin infection might lead to ulceration as well.
Any ulcer below the knee level that does not heal within a six-week period is defined as a chronic leg ulcer.
It is important to understand that the treatment of arterial ulcers requires a different approach than the treatment of venous ulcers.
Arterial ulcers are usually treated with arterial stent, or arterial bypass grafting done in a hospital setting.
Venous ulcers do not require a hospital stay. Treatment plans might include debridement of the infected skin and wound, stimulation of the ulcer surface, customized dressings and multilayer compression adjusted for the patient's arterial blood pressure. Eventually, the reverse blood flow that caused venous ulcer has to be corrected.
If you have questions, schedule a consultation with Dr. Jozef Tryzno, MD, Diplomate of the American Board of Venous & Lymphatic Medicine and Registered Vascular Technician.