Is a drug reaction the cause of this patient’s pruritus?

Two months of scratching her itchy lower legs have sent a 62-year-old woman to her physician. The pruritus began shortly after she started taking a calcium channel blocker for hypertension.

Can you identify this condition?

A. Stasis dermatitis.
B. Adverse drug reaction. 
C. Contact dermatitis.
D. Asteatotic eczema.
E. Lichen simplex chronicus.

(Answer on next page)

Answer: Stasis dermatitis

Some antihypertensive medications cause fluid retention with secondary pitting edema, which results in stasis dermatitis, A. The addition of a diuretic to this patient’s regimen improved the condition dramatically. Topical corticosteroids will alleviate symptoms temporarily.

This patient had no history of contact dermatitis, and lichen simplex chronicus generally erupts on the lateral aspect of the legs. Patches of dry skin typical of asteatotic eczema would be elsewhere on the body as well. A drug reaction causes more extensive lesions.