S1 guideline: Differential diagnosis of acute and chronic redness of the lower legs.


Journal

Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
ISSN: 1610-0387
Titre abrégé: J Dtsch Dermatol Ges
Pays: Germany
ID NLM: 101164708

Informations de publication

Date de publication:
07 2022
Historique:
received: 09 03 2022
accepted: 16 04 2022
pubmed: 28 6 2022
medline: 29 7 2022
entrez: 27 6 2022
Statut: ppublish

Résumé

Acute or chronic redness of the lower leg is a frequent reason for visits to clinics and practices. The differential diagnosis is often challenging. The aim of this guideline is to define criteria and procedures for the differential diagnosis of acute or chronic, unilateral or bilateral redness of the lower leg. Finding the correct diagnosis is essential for selecting an appropriate treatment and can help to reduce the inappropriate use of antibiotics. The guideline committee identified the most relevant differential diagnoses: 1. erysipelas, 2. stasis dermatitis, 3. hyperergic ictus reaction, 4. superficial and deep vein thrombosis, 5. gout, 6. chronic allergic contact dermatitis, and 7. acute toxic or allergic contact dermatitis. Algorithms/diagnostic pathways, each of which can be broken down into anamnesis, clinical examination, and diagnostics, have been developed for these seven diagnoses. In addition, the guideline group identified over 40 other relevant diagnoses and summarized their characteristics in a table to facilitate further differential diagnoses.

Identifiants

pubmed: 35758562
doi: 10.1111/ddg.14816
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1041-1047

Informations de copyright

© 2022 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.

Références

Weng QY, Raff AB, Cohen JM et al. Costs and consequences associated with misdiagnosed lower extremity cellulitis. JAMA Dermatol 2017; 153: 141-6.
Levell NJ, Wingfield CG, Garioch JJ. Severe lower limb cellulitis is best diagnosed by dermatologists and managed with shared care between primary and secondary care. Br J Dermatol 2011; 164: 1326-8.
Patel M, Lee SI, Thomas KS, Kai J. The red leg dilemma: a scoping review of the challenges of diagnosing lower-limb cellulitis. Br J Dermatol 2019; 180: 993-1000.
Drerup C, Eveslage M, Sunderkoetter C, Ehrchen J. Diagnostic value of laboratory parameters for the discrimination between erysipelas and limited cellulitis. J Dtsch Dermatol Ges 2020; 18: 1417-24.
Drerup C, Eveslage M, Sunderkötter C, Ehrchen J. Diagnostic value of laboratory parameters for distinguishing between herpes zoster and bacterial superficial skin and soft tissue infections. Acta Derm Venereol 2020; 100: adv00009.
Sunderkötter C, Becker K, Eckmann C et al. S2k-Leitlinie Haut- und WeichgewebeinfektionenAuszug aus „Kalkulierte parenterale Initialtherapie bakterieller Erkrankungen bei Erwachsenen - Update 2018“. J Dtsch Dermatol Ges 2019; 17: 345-71.
AWMF. S2k-Leitlinie Venenthrombose und Lungenembolie: Diagnostik und Therapie (065-002). Available from: https://www.awmf.org/leitlinien/detail/ll/065-002.html [Last accessed July 12, 2021].
Ogdie A, Taylor WJ, Weatherall M et al. Imaging modalities for the classification of gout: systematic literature review and meta-analysis. Ann Rheum Dis 2015; 74: 1868-74.

Auteurs

Miriam Zidane (M)

Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.

Hans-Wilfried Jungkunz (HW)

Practice Dr. Wilfried Jungkunz, Friedberg, Germany.

Birgit Kahle (B)

Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein Campus Lübeck, Germany.

Anya Miller (A)

Practice Dr.med. Anya Miller, Berlin, Germany.

Falk Ochsendorf (F)

Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany.

Cord Sunderkötter (C)

Department of Dermatology and Venereology, University Hospital Halle (Saale), Germany.

Claudia Traidl-Hoffmann (C)

Institute of Environmental Medicine (IEM), Medical Faculty Augsburg, University Hospital Augsburg, Germany.

Gerda Wurpts (G)

Department of Dermatology and Allergology, Aachen Comprehensive Allergy Center (ACAC), University Hospital of RWTH Aachen, Germany.

Alexander Nast (A)

Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.

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Classifications MeSH