History:

 A 55-year-old obese (BMI > 30) woman presented with an itchy red rash confined to both lower limbs of 5 months duration. No history of DM, HT or other diseases. No history of drug intake except a course of 12 injections of Cefotaxime 1g given im on daily basis prescribed by a general surgeon without any improvement.  O/E, a red, oozy, eczematous rash of long duration associated with oedema and some varicosities. She had normal CBC and her Venous Doppler study revealed severe valve damage and venous hypertension. She was treated with K-permanganate (1/8000) wet compresses topical potent corticosteroids and systemic antibiotic (Cephalexin 500 mg four times daily) for 2 weeks with very good improvement then continued on moderate topical CS alone for further three weeks with excellent response.