venous eczema – Diagnosis

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How is venous eczema diagnosed?

Venous eczema of the lower leg

The diagnosis of venous eczema is based on two factors:
  1. Firstly someone has to actually think of the diagnosis
  2. A duplex ultrasound scan of the veins by a trained and experienced expert
A great many people have discolouration around the ankles either red or brown, and a large number of these will be due to venous eczema. Unfortunately, the majority of these people will either not bother to seek medical advice or, if they do, will have the wrong advice from their family doctor, dermatologist or nurse.

Venous eczema is often misdiagnosed as normal skin eczema or “phlebitis“, with the results that they get given the wrong treatment (see below) and very few people get sent for a duplex ultrasound scan which will diagnose the problem.

In order to treat venous eczema successfully, everybody with suspected venous eczema should have a venous duplex ultrasound scan performed by an expert. This should take approximately 30 to 45 minutes in most cases, if a full examination is being performed.

For an accurate duplex ultrasound examination, the patient needs to be standing up with their weight on the other leg, or sitting or leaning in a position where gravity can allow blood which is in the veins to fall backwards down the veins if the valves are not working.

It is impossible to perform a venous duplex ultrasound scan for venous eczema with the patient lying down. If the patient is lying down, gravity cannot make the blood fall down the veins and so the veins will always look normal and the diagnosis will be missed.

The venous duplex ultrasound scan, when performed by an expert correctly, will:

  • confirm the diagnosis that it is venous eczema
  • will show which veins have lost their valves and so can be used to guide successful treatment

Next page: How venous eczema is treated

This website was last updated on 11/10/16.