40 yrs female with this marks on her both leg only. since 2-3

Allergy & Immunology

40 yrs female with this marks on her both leg only. since 2-3 yrs. no any other complaints. please help in diagnosis and treatment

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Dr. Puranjoy Saha

Microbiology

Dx :- Stasis dermatitis. Stasis dermatitis is a common inflammatory skin disease that occurs on the lower extremities. It is usually the earliest cutaneous sequela of chronic venous insufficiency with venous hypertension and may be a precursor to more problematic conditions, such as venous leg ulceration and lipodermatosclerosis. Rx :- Treatment Approach Considerations :- Although extensive work has been completed in the study of venous ulcer treatment, no large, well-controlled trials have examined the treatment of stasis dermatitis. The overall mainstay of treatment has always been aimed at lessening the clinical impact of the underlying venous insufficiency and edema, a goal that is typically accomplished with compression therapy. Ligation :- Stasis dermatitis related to an arteriovenous fistula or incompetent perforators may respond to ligation of the vessels. Light :- Combination therapy with autologous platelet-rich plasma and light-emitting diodes shows some promise in the treatment of refractory stasis ulcers. Stasis pigmentation, resulting from hemosiderin deposition, is notoriously difficult to treat and typically does not resolve even when the underlying stasis dermatitis is well controlled with topical therapy. However, some authors have reported improvement of stasis pigmentation after treatment with a noncoherent intense pulsed light (IPL) source. Compression Therapy :- Assessing the patient's peripheral arterial circulation (clinically or with a Doppler study) before recommending compression therapy is important. Adding compression to a leg with compromised arterial circulation could increase claudication and put the patient at risk for ischemic damage. Compression accomplished by means of specialized stockings that deliver a controlled pressure gradient (measured in mm Hg) to the affected leg are suitable for long-term management of edema, but not for healing of stasis ulcers. Compression stockings should be applied early in the morning, before the patient rises from bed, in order to facilitate application when leg edema is at its lowest point. High-level compression can be performed by using elastic wraps, compression (Unna) boots, and more sophisticated devices, such as end-diastolic compression boots. Most of these modalities require administration in a physician's office or wound care center. Frequent leg elevation is a necessary adjunct to leg compression. Grafting :- Allogeneic cultured dermal substitutes have been used, but are expensive. Most patients respond to high-level compression alone. Patient compliance :- Counseling patients regarding the use of compression therapy is vital to the successful management of stasis dermatitis. Thank you very much Dr. Shila Turbe for sharing this post.

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Dr. Puranjoy Saha

Microbiology

Prognosis :- Complications of chronic stasis dermatitis include cellulitis and nonhealing venous ulcers. Direct consequences of stasis dermatitis include an increased incidence of allergic contact dermatitis, lower-extremity ulceration, lipodermatosclerosis, and id reaction (autoeczematization).

Dr. Avitus John Raakesh Prasad

Dermatology

Dr Shaila I agree with with others It's a case of schamberg purpura. Treatment Pentoxifylline or Trental 400mg Calcium dobesilate 500mg Aloevera based cream in morning Mometasone cream in night for first 6 weeks then stop Patient should avoid long periods of standing. Vit C 1000mg helps.