Varicose (venous) eczema

Varicose eczema is also known as gravitational, stasis or venous eczema. It occurs in the lower limbs of patients suffering from venous hypertension. An eczematous pattern is present on one or both limbs; the skin is dry, flaky, irritated and inflamed (see Figure 9.9). The skin is fragile and can break down easily, leading to the formation of venous leg ulcers.

It is not uncommon in the community to see a range of erythematous eczema-like lesions affecting the lower leg. Although all are red, eczema is always itchy or sore with broken skin. Superficial thrombo-phlebitis is localised to a vein and tends to be linear and tender, whereas cellulitis is a deep dermal and subcutaneous condition, with painful inflammation and is usually accompanied by a pyrexia and diffuse oedema (Ryan, T., University of Oxford, Oxford, pers. comm.).