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INTRODUCTION

The legs are predisposed to dermatoses that are gravity-dependent, including stasis dermatitis and vascular conditions such as leukocytoclastic vasculitis, the pigmented purpuric dermatoses, and livedo reticularis. Legs are also the site of frequent trauma and thus are susceptible to conditions that may be induced by trauma including superficial thrombophlebitis, pyoderma gangrenosum, necrobiosis lipoidica, chronic ulcers, and cellulitis. In patients with pre-existing vascular conditions affecting the lower extremities, including diabetes mellitus, venous insufficiency, and peripheral vascular disease, traumatic wounds may take longer to heal with an increased risk of infection.

APPROACH TO DIAGNOSIS

Skin diseases involving the arms can be broadly placed into the following categories starting with the most common diseases (Table 39-1):

  • Inflammatory Dermatoses

  • Infectious Diseases

  • Neoplasia

  • Systemic Diseases

  • Vascular Diseases

Table 39-1.Differential diagnosis for skin diseases of the legs.

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