Gravitational Eczema

Key Points
Condition results in an itchy rash occurring on the lower legs due to damage to the valves in the leg veins.
The affected leg is usually swollen, and the rash causes itchy, red scaly patches and may ooze, crust and crack.
Condition can lead to a number of complications.

Statis or gravitational dermatitis is an itchy rash occurring on the lower legs due to a venous disease. Normally during walking, the leg muscles pump blood upwards and valves in the veins prevent pooling. A clot in the deep leg veins or varicose veins may damage the valves. As a result, back pressure develops and fluid collects in the tissues. The affected leg is usually swollen, particularly after prolonged standing and during hot weather. Swelling is due to inflammation and lymphoedema. Dermatitis can arise as patches or occur around the entire leg. The affected skin is itchy, red and scaly, and may ooze, crust and crack.

Any number of complications can result, including impetiginisation, cellulitis, autosensitisation reaction, lichenification, hyperpigmentation, lipodermatosclerosis, atrophie blanche, ulceration, and contact allergy to treatment.

Differential Diagnosis (Other conditions with similar appearance)
Asteatotic Eczema
Atopic Dermatitis
Cellulitis
Contact Dermatitis
Cutaneous T-cell lymphoma
Necrobiosis lipoidica
Nummular Dermatitis
Pigmented Purpuric Dermatitis
Pretibial Myxedema
Tinea Pedis

Diagnosis
Key Points
Diagnosis is primarily performed through clinical inspection.

Diagnosis is primarily performed through clinical inspection to eliminate other diseases as the root cause.

Treatment
Key Points
Treatment of the swelling of the legs is mostly prevention.
Treatment of the dermatitis involves various creams and topical ointments.

Treatment can be useful to alleviate the various conditions and causes of the dermatitis. To reduce swelling in the leg, don't stand for long periods, take regular walks, elevate your feet when sitting, elevate the foot of your bed overnight, and wear special compression stockings long term.

To treat the dermatitis, dry up oozing patches with potassium permanganate or dilute vinegar on gauze as compresses, take oral antibiotics, apply a topical steroid in gradually lesser potency, use a moisturizing cream, try not to scratch, and protect your skin from injury. Also, if you have varicose veins, get them treated as soon as possible.