Eczema of the leg

Eczema of the leg is very frequently dependent on preexisting varicose veins, and when such is the case is difficult to manage, unless the diseased veins can themselves be brought under control. If the varicose condition be at all severe, the general nutrition of the skin of the leg seems to suffer greatly, and a slight wound from scratching may degenerate into an ulcer. The cutaneous tissues, which are the site of the lesion, and for a considerable space around it, may be greatly thickened, and the surface present a bluish tint from impeded circulation. When this condition exists, the utmost benefit will be secured from the syste­matic use of the rubber bandage applied so as to bring firm but even pressure to bear upon the parts. The bandage should, in the first instance, be applied by the physician, and the mode of its application taught the patient. The bandage should, when practicable, be applied morning and night, and, if it becomes soiled by discharges of any kind, should be replaced by a fresh one, while the first one is permitted to soak in cold water till again needed. After the leg has been restored to its natural size, the bandage may be discarded, but an ordinary elastic stocking should be worn habitually. The direct applications to be made will depend on the stage of the eruption and condition of the lesion.


Eczema of the leg, however, is not always of varicose origin, but sometimes presents itself as a chronic subacute circumscribed lesion, with or without much infiltration. If scaling be a notable feature - that is, with decided epidermic thickening and proliferation - a few applications of salicylic acid will prove of great service as a preliminary application, and a ten or fifteen grain solution in flexible collodion should be painted over the spot. This may be repeated a few times until the tendency to scale formation has notably diminished. If there be but little infiltration, tar, or some of its preparations, is indicated; but if infil­tration is marked, potash or scarification should be em­ployed and afterward zinc or white precipitate ointment.


Acute eczema of the leg requires different treatment. If the greater part of the leg or both legs are involved, rest in bed or on a lounge, with the limbs elevated, is a sine qua non. The parts, being inflamed, hot, red, swollen, and exuding, need rest and soothing treatment. Absolute rest must be insisted on, and when secured apply a diluted solution of peroxide of hydrogen. The best method of applying it is with an atomizer. Purulent exudation is brought under immediate control, and offensive odors are destroyed. After two or three days, as a rule, the inflammation will be lessened, the area of denuded surface diminished, and at-' tempt at healing be apparent. Now, some of the medicated plasters containing oxide of zinc or ammoniated mercury should be applied. These, may be left undisturbed for several days, and if covered with an elastic stocking the patient may be permitted to take moderate exercise. If no indis­cretions be committed, steady progress toward cure may usually be expected.