Venous Eczema — SCE Dermatology MCQ

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EasyWound HealingVenous EczemaSCE Dermatology

A 50-year-old man with chronic venous insufficiency has bilateral lower leg changes including haemosiderin deposition, lipodermatosclerosis, and varicose eczema. He develops an acute flare of his venous eczema. What is the first-line topical treatment for acute venous eczema?

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Correct answer: D — Moderate-to-potent topical corticosteroid and emollients

Acute venous (stasis/gravitational) eczema requires treatment with moderate-to-potent topical corticosteroids alongside emollients to control inflammation. Compression therapy (graduated compression bandaging/hosiery, ABPI must be >0.8) is the mainstay of underlying venous disease management and should continue alongside topical treatment. Topical antibiotics should be avoided due to high risk of contact sensitisation in this patient population (sensitivity to neomycin, fusidic acid, lanolin). If secondary infection is suspected, oral rather than topical antibiotics are preferred. Patch testing should be considered if eczema is not responding to treatment.

Reference: NICE CG168 2013 Varicose Veins; BAD