Gravitational (stasis) eczema

Gravitational (stasis) eczema

Cause

Often, but not always, accompanied by obvious venous insufficiency.

Presentation and course

A chronic patchy eczematous condition of the lower legs, sometimes accompanied by varicose veins, oed-ema and haemosiderin deposition (Fig. 7.26). When severe it may spread to the other leg or even become generalized.

Complications

Patients often become sensitized to local antibiotic applications or to the preservatives in medicated bandages. Excoriations may lead to ulcer formation.

Treatment

This should include the elimination of oedema by el-evation, pressure bandages or diuretics. A moderately potent topical steroid may be helpful, but stronger ones are best avoided. Bland applications, e.g. Lassar’s paste or zinc cream BNF, or medicated bandages  are useful but stasis eczema is liable to persist, despite surgery to the underlying veins.