The observation of Hruza and Hruza1 attributing dermatitis at the site of saphenous venectomy to a sensory deficit resulting from saphenous nerve trauma warrants comment. The clinical and histopathologic figures illustrating the features of their cases are typical of asteatotic dermatitis (eczema craquelé). Although the authors mention eczema craquelé, they do not provide the information leading them to disregard this diagnosis.
Patients subject to coronary bypass surgery and saphenous vein excision are usually at least middle aged and, hence, susceptible to xerosis. Ancillary to wound care concerns, bathing is likely to occur daily. Since the saphenous nerve subserves sensory innervation for the medial aspect of the leg (as well as the medial aspect of the ankle and proximal aspect of the foot), hypoesthesia resulting from injury would diminish itching and burning awareness of overbathing practices. Patients with an intrinsic tendency to xerosis from an atopic diathesis are likely candidates
McGrae JD. Dermatitis of the Leg Following Saphenous Venectomy. Arch Dermatol. 1994;130(1):115. doi:10.1001/archderm.1994.01690010121024
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