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Differentiating between red legs and cellulitis

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 Deep vein thrombosis Deep vein thrombosis seen in the left leg of the patient; her right leg appears normal

Red legs is a condition commonly seen in patients with chronic venous disease (CVD), chronic oedema, or lower-limb dermatological conditions. It is often misdiagnosed as cellulitis.1 Studies have shown that around 28%-33% of patients treated for cellulitis are misdiagnosed, which subsequently leads to avoidable and costly hospitalisation and potentially hazardous use of intravenous antibiotics that may compound the evolution of antibiotic-resistant bacteria.2,3 Over a period of seven years, there has been an increase of 77% in the number of people admitted to hospital for management of lower-limb cellulitis,4 costing the NHS between £172-£254 million per year.5 The aim of this article is to raise awareness of red legs and highlight the differential diagnoses. As a result, nurses may be able to avoid misdiagnosing cellulitis and improve a patient’s experience, as well as avoid costly hospitalisation and antibiotic therapy.

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Erythromelalgia also can present with red legs that are brought on by heat, exercise or spicy foods and relieved with elevation and cooling with a fan.
Posted by: ,
I have had this problem for over 10 yrs... I have been to several Drs. One told me it was sunburn.
I'm 54 and not Obese by American standards never over 135. Currently, I'm a petite sz 2-4. I have had vein testing and have been given a clean bill of health. Still, my legs are bright red and getting worse. I noticed the skin has started to get scaly. I honestly don't know what to do.
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Finally I can't believe I came across this article. It must be faith . I have see doctors after doctors they kept giving meds for a fungus and it would not help. My left side foot and Leg have been doing this for 6yrs. I thought. It has to do when I cut my foot underneath my toes. Thank you so much?
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This was the article I have been looking for! Thank you so much for publishing it. I have been to see several doctors for my left leg and each time they poke the leg, and right away start me on antibiotics to treat cellulitis. I keep telling them that yes at the moment I make an appointment it may appear to be that but if they just listen to sequence of conditions they could actually be doctors. My left leg become extremely painful, followed by a dark, hot to the touch band that goes completely around my lower leg then 3-4 days later edema sets in. I took pictures and everything to show progression but they just say morbidly obese, edema, cellulitis. I stopped going to the doctors but your article has given me some hope that maybe one of them can use the information you have provided to correctly diagnose my condition which comes and goes every few months.
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Very interesting and informative article: I have been diagnosed with lower leg, unilateral cellulitis four times in the last 18 months; I've also recently had impetigo, boils & a stye. My legs are still sore and tender: but I'm worried about having flucloxicillin so frequently, that resistance might occur ... I will now go back to my GP & request microbiology before any more antibiotics, and try to moisturise with Zerocream daily. This info should be more widely available! Thanks so much
Posted by: ,
Very good reading and educational,my husband has seen DR.for a couple of years for the red patch, keep creaming that's what been told!! Two days ago it was turned very hot and red ,than 111 advice to go to A&E suspect blood clots ok!! We went to A&E, after a few hours of blood test and questions and answers,we came home with antibiotics to take. this morning his leg still very hot and red just hope antibiotics work next 48 hours!!! After reading the article I now know a bit more about what could it be!!! Just try living healthy!!!! Thanks
Posted by: ,
I am delighted to read this article. In my practice as Director of a Wound Healing Company and a Tissue Viability Consultant Nurse, it is absolutely amazing how many people I see that have been having antibiotics for months for an 'infection' and when I apply some steroid ointment, the redness is gone within a few days.
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Thank you for this article. My Mother (91) has had redness and swelling in her legs for many years. She suffers from Pagets disease (mainly manifests itself in the right leg) and arthritis, and has had inconsistent treatment, if any, for the redness and swelling. I suspect this is due to it being thought that 'it is your age' . Having read this article I now feel it is important to revisit her medical care and not accept the status quo, and push for a coordinated aporoach to improve her condition.
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Thank you, I will quote this in my lecture to GPs. I am working with Dr Jungkunz to look at skin using ultrasound for the differential diagnosis of various leg disorders/disease, and the proving the effect of compression to prevent lipodermatosclerosis
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