Limb examination - continued

  • Atrophie blanche. white areas of decreased capillary density (ischaemic skin), that can be painful and herald the site for future ulceration

Leg Ulcer 7 

  • Venous eczema is idiopathic and  presents as itchy, erythematous, weeping and scaled areas of skin that may be painful. Venous eczema can be wet or dry and can be misdiagnosed as cellulitis. Please note bilateral cellulitis is a very rare event and is frequently misdiagnosed when the patient is actually presenting with bilateral infected varicose eczema

 Leg Ulcer 8

NB: all the above contribute to skin fragility and increased risk of leg ulceration and delayed healing.

Lipodermatosclerosis can be present without ulceration and in this situation preventative compression hosiery should be prescribed. This highlights the need to assess both lower limbs rather than just the one with the ulceration.


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