Venous eczema

Question 1

What are clinical features?

Answer 1

Occur in gaiter region- middle of calf down to malleoli
Wound edges are sloping and irregular
Sign of venous insufficiency
- pitting oedema, hyperpigmentation, varicose veins, lipodermatosclerosis

Question 2

What are the management of venous ulcers?

Answer 2

Compression banding
Pentoxifylline 400mg TDS- can aid ulcer healing by improving blood flow
Treat infection if required with abx
- fluclox 1st line
- doxy/clari if pen allergic

Question 3

What investigations are required?

Answer 3

ABPI to rule out arterial disease

ABPR results
- 0.8-1.3= normal
- <0.5 severe arterial disease (compression contraindicated)
- 0.5-0.8 arterial disease (avoid compression)
- >1.3 suggests arterial calcification (use compression with caution)