Also called pigmented angiodermatitis or purpuric angiodermatitis, ocher dermatitis is a skin disease, which is characterized by the appearance of spots resulting from a displacement of the blood contained inside the vessels towards the skin. These spots most often appear on the lower legs. Ocher dermatitis must be taken care of in order to avoid its progression as well as the complications that can result from it. Its management is based on the treatment of symptoms and causes. It depends on the area to be treated, the nature of the lesion or the patient’s phototype.

Ocher dermatitis, also called angioderma pigmentosa, angiodermatitis pigmentosa or purpuric angiodermatitis, is a skin disease that affects the lower limbs, in particular the inner part of the ankles and the front part of the shins. It is characterized by the presence of multiple brown-yellowish spots, often converging towards each other, located in the lower third of the leg, in the area of ​​the internal and external malleolus, on the ankle and on the arch of the foot. It is a condition that first manifests as red-purple spots, which turn brown. It can affect only one leg or both legs at the same time, and the spots can be more or less extensive depending on the individual.

The ocher dermatitis results from the rupture of the capillaries – the small superficial blood vessels located under the skin – which causes the massive outflow of blood which will invade the neighboring tissues. Usually, this rupture of the capillaries is due to excessive venous pressure, occurring after the appearance of varicose veins, or as a result of the Ocher dermatitis results from the rupture of the capillaries – the small superficial blood vessels located under the skin – which causes the massive outflow of blood that will invade neighboring tissues. Generally, this rupture of the capillaries is due to an excessive venous pressure, occurring after the appearance of varicose veins, or following disorders related to a phlebitis. This results in the release and deposition of the iron contained in the hemoglobin, which is gradually deposited in the skin tissue, giving it an ocher color, hence the term “ocher dermatitis”. It is a sign of venous insufficiency which can progress to ulceration of the skin if left untreated.

Ocher dermatitis can also be observed:

• after a purpura (mini hemorrhage in the skin);
• after a hematoma (bluish lesion due to the presence of blood, swollen and bulky);
• in patients taking anti-coagulants, aspirin or Plavix®.

Despite the fact that the clinical symptoms are not severe, the aesthetic factor is of considerable concern to patients, especially women who want to be able to continue to wear clothing that shows their legs.

• skin atrophy, that is, reduction in the thickness and strength of the skin;
• bacterial infections;
• an ulcer (sore) on the leg.

Ocher dermatitis must be taken care of in order to avoid its development and the complications that may result from it. Its management consists of treating the symptoms and the causes. It depends on the area to be treated, the nature of the lesion or the patient’s phototype.

Skin antisepsis

The treatment of ocher dermatitis is based on antisepsis, that is to say the destruction of microorganisms present in the tissues, by the application of creams, available on prescription, acting against microbial germs. This not only relieves irritation, but also gradually eliminates stains on the legs.

Skin depigmentation

Depigmenting treatments include:

• topical whitening treatments such as hydroquinone, topical corticosteroids, retinoic acid, kojic acid, azelaic acid, glabridin, N-cysteamine, vitamin C or even vitamin E;
• chemical peeling with glycolic acid, trichloroacetic acid (TCA), or phenol;
• subcutaneous injection of deferoxamine mesilate, which is an iron chelator;
• the depigmenting laser;
• Intense Pulsed Light (IPL).

Treatments to tackle the causes of ocher dermatitis

These first measures can be supplemented by:

• surgery or medical treatment aimed at restoring circulation to the affected vessels;
• a thermal cure or thalassotherapy, including lymphatic drainage, to stimulate the venous system and improve blood circulation. The virtues of thermal waters, in the treatment of venous insufficiency, are indeed recognized for their effectiveness.

Accompanying measures

It is also recommended to:

• raise the legs and compress the superficial veins by using compression stockings on a regular basis. This will effectively help to limit the spread of blood in the skin tissues;
• walk regularly;
• perform lymphatic massages;
• avoid standing or sitting for a long time;
• avoid crossing your legs while sitting;
• keep your skin clean and dry at all times.