What is the best way to treat a morbidly obese man with bilateral stasis dermatitis and ulcers that are resistant to local antibiotics?
—Elizabeth Oommen, MD, Hicksville, N.Y.
Leg elevation and use of emollients are important first steps. If there is pruritus and erythema of the skin, a topical corticosteroid may be indicated. For the ulcers, a dressing such as Duoderm may be useful. If these initial steps are not helpful, weekly application of an Unna boot is an option. I try to manage patients with input from a vascular surgeon. In an obese patient, weight loss would certainly help to ameliorate the problem.
—Jeffrey M. Weinberg, MD (109-14)