Recently, you have noticed that the skin on one or both of your legs has become red, swollen, rashy, and often painful. It is probable that you may have been diagnosed with ‘cellulitis’, a common infection caused by bacteria as they enter through a crack or break in the skin. It affects the soft tissue, particularly the dermis, and other structures below the top layer of your skin.
Recent evidence-based research shows that the number of cases misdiagnosed as ‘cellulitis’ is very high. More than 10 % of those labeled as having cellulitis did not have cellulitis. Wrong diagnosis has resulted in unnecessary hospitalization. This is unfortunate as patients were treated with antibiotics and topical steroids unnecessarily for years leading to its potential waste and overuse, not to mention the delay in providing relevant therapy.
Red, swollen skin on the leg may be due to cellulitis, but it can also be indicative of several other medical conditions. A condition often misdiagnosed as cellulitis is ‘Venous stasis dermatitis.’
Diagnosing Cellulitis and Venous stasis dermatitis
Cellulitis is a common and potentially serious bacterial infection which usually affects only one area of one leg. Hence, an appropriate way to determine if someone may or may not have cellulitis is to check if the infection is present in both legs. If a patient presents with “bilateral cellulitis” on both legs, probably he has Venous stasis dermatitis.
Unlike cellulitis, venous stasis dermatitis affects both legs. In addition, if the suspected cellulitis is not getting cleared after prolonged antibiotics therapy, it implies the need for other problems to be assessed.
An alert experienced physician can find clues in the patient’s medical history. His physical examination followed by a venous duplex scan may diagnose a patient with chronic venous insufficiency.
Cellulitis is typically painful and the affected area feels hot and tender to touch. However, venous stasis dermatitis is generally benign and does not cause pain or fever to the patients. They mostly complain about itchiness rather than pain.Cellulitis usually affects the lower legs, but can occur anywhere in the body.
What Is Venous insufficiency and Stasis Dermatitis?
Your veins have one-way valves that help blood flow upward, against the gravity towards the heart. If these valves turn faulty, blood starts to flow sluggishly towards the feet and begins to pool around the valve in the lower legs. The condition, referred to as chronic venous insufficiency (CVI), is mostly found in the legs.
Faulty veins can cause discoloration of the skin in the legs when the blood pools in the vessels. As the pressure inside the blood vessels increase, the fluid starts to leak into the surrounding tissues leading to the discoloration of the legs and ankles. Untreated CVI can cause ‘venous stasis dermatitis or venous ezcema.’ The skin color turns reddish brown and you experience pain, itching, skin hardening, and sores are developed that look scaly and occasionally oozes
Treatment for Venous insufficiency
Inflammation caused by vein disease is not caused by infection and will not respond to antibiotics. Blood circulation is the main reason for vein problems. Hence, its treatment requires closing the diseased vein thereby sending blood circulating to nearby healthier veins.
To get the fluid to circulate in your legs, there are several treatment methods currently available. Radiofrequency ablation, laser ablation, and sclerotherapy are few procedures that can treat both the underlying vein disease and any accompanying skin abnormalities.
If you notice a change in the texture or color of your skin, visit Avis Vascular center and let our doctors help you determine the cause and a suitable course of treatment.
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