Differentiating between red legs and cellulitis

Red legs is a condition commonly seen in patients with chronic venous disease (CVD), chronic oedema, or lower-limb dermatological conditions. It is often misdiagnosed as cellulitis.¹ Studies have shown that around 28%-33% of patients treated for cellulitis are misdiagnosed, which subsequently leads to avoidable and costly hospitalisation and potentially hazardous use of intravenous antibiotics that may compound the evolution of antibiotic-resistant bacteria.^2,3 Over a period of seven years, there has been an increase of 77% in the number of people admitted to hospital for management of lower-limb cellulitis,⁴ costing the NHS between £172-£254 million per year.⁵ The aim of this article is to raise awareness of red legs and highlight the differential diagnoses. As a result, nurses may be able to avoid misdiagnosing cellulitis and improve a patient’s experience, as well as avoid costly hospitalisation and antibiotic therapy.