A 67-year-old woman presents to the vascular surgeons with varicose veins. She had a history of venous ulceration in the past, which has now healed and she is being considered for bilateral varicose vein surgery. At the consultation, she complained of a 3-month history of skin itching and redness, particularly on the right lower leg, and was noted to have unilateral erythema and was referred to dermatology for an opinion. Examination This patient has obvious dilated and tortuous veins on both lower legs.
Confluent background dull erythema is seen on the right lower leg, with small inflammatory superficial erythematous erosions and excoriations (Attached Figure). Palpation revealed warm, dry, rough skin at the affected site. Investigations Vascular studies Resting pressure right: 174 mmHg, left: 180 mmHg, brachial: 167 mmHg Resting ankle/brachial pressure index right: 1.042, left: 1.078.…
