September 21, 2023

  1. Michael Tran, lecturer and common practitioner1 2,
  2. Vivienne Lea, anatomical pathologist3,
  3. Cathy Zhao, scientific lecturer in dermatology4,
  4. Sean Kristoffersen, common practitioner5
  1. 1Division of Basic Observe, The College of New South Wales, College of Inhabitants Well being, NSW, Australia
  2. 2Erskineville Medical doctors, Newtown, NSW
  3. 3Division of Anatomical Pathology, Liverpool Hospital, Sydney, NSW
  4. 4The College of Sydney, NSW
  5. 5Church Road Medical Observe, Newtown, NSW
  1. Correspondence to: M Tran

What it’s essential to know

  • Complete evaluation of venous eczema contains asking about triggers, time course of signs, discomfort or ache, problems, and high quality of life

  • Efficient administration is multifaceted, and requires affected person engagement and concurrent remedy of contributing way of life elements

  • Frameworks such because the revised venous scientific severity rating might help categorise and monitor the burden of illness and information administration

A person in his 70s with hypertension, a physique mass index of 30, and decreased mobility presents with a six month historical past of erythematous, scaling patches over his decrease limbs, that are persistently oedematous. The rash is itchy and weeping. Moisturising has not improved his signs, and he’s involved about an infection.

This text will assist you to grasp the indicators and signs of power venous illness, with a deal with the complication of venous eczema. It gives steering and a framework on how you can handle the situation in a neighborhood setting.

What it is best to cowl

Historical past

Venous eczema is a typical inflammatory dermatosis of the decrease extremities, occurring in sufferers with power venous illness.1 It happens secondary to power irritation, which arises from venous hypertension and a failure of the venous pump, obstructed venous circulation, and dysfunctional venous valves, with reflux of blood from deep into now excessive strain superficial venous programs (fig 1).1 Signs of venous eczema differ in line with chronicity. Preliminary presentation might be extremely variable and overlap with signs of power venous illness, together with decrease extremity heaviness, aching, swelling, itching, and discomfort.2 Exclude differential diagnoses (field 1).

Fig 1

Pathophysiology of power venous illness and venous hypertension

Field 1

Differential diagnoses of venous eczema


  • Cellulitis

  • Irritant or allergic contact dermatitis

  • Asteatotic eczema (eczema craquele)

  • Lichen simplex chronicus

  • Psoriasis

  • Dermatophyte an infection (tinea corporis)

  • Actinically broken pores and skin (solar injury)

  • Autosensitisation dermatitis (secondary dermatitis that has developed at a location distant from the first inflammatory focus)


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