A 67-year-old woman presents with a six-month history of an itchy, red rash on both lower legs. She also reports leg swelling that worsens by the end of the day and improves with elevation. Over the past few weeks, the skin has become darker, scaly, and slightly thickened, with occasional weeping of fluid. She denies fever, trauma, or recent changes in skin care products.

Her medical history includes hypertension and varicose veins, but she has no known allergies or history of eczema. She does not smoke and has no history of diabetes.

On examination, there is bilateral leg edema, with erythematous, hyperpigmented patches on the medial lower legs. The skin appears dry, scaly, and slightly thickened, with mild oozing in some areas. There are no ulcers, but hemosiderin staining (brown discoloration) is visible. Peripheral pulses are intact, and there are no signs of infection. A clinical diagnosis of stasis dermatitis is made, likely due to chronic venous insufficiency.

She is advised to elevate her legs, use compression stockings, and apply moisturizers and mild topical corticosteroids to reduce inflammation. She is also referred for a vascular assessment to evaluate her venous circulation.