Thank you for the information and additional photograph. Your clinical picture is most suggestive of a condition called Pigmented Purpuric Dermatosis (PPD). Pigmented Contact Allergic Dermatitis
(PCAD) would be a second possibility but is less likely.
PPD is a harmless condition caused due to microvascular leakage of blood into the skin leading to hemosiderin deposition. This occurs either spontaneously or on prolonged standing or walking. The basic cause is due to poor capillary support as the anchoring proteins which do this job in the skin decrease with a mild inflammation of the smallest blood vessels called capillaries (capillaritis). Sometimes there can be an element of venous back flow as well on account of varicose veins or a problem with the deep veins of the leg. A sign of this can be leg swelling at the end of the day or swollen veins in the back of the leg.
This condition has many variants and your particular variant looks closest to pigmented purpuric dermatosis of Schamberg.
No treatment is required for the red/brown spots. The condition is essentially harmless and usually keeps recurring and fading. Ultimately there may be some hyperpigmentation in the involved area.
Still if you are keen to pursue treatment then here is what I would recommend:
1. Tab Calcium Dobesilate 500 mg twice a day for 6 weeks. Other Flavonoids can also help - e.g Pentoxifylline, Daflon 500.
2. Tab Vitamin C 500 mg once a day.
3. Fluticasone propionate cream twice a day for 7-14 days. Then once at night for 2 weeks and the once at night every fourth day for maintenance. Stop this gradually over 2-3 months.
4. Avoid prolonged standing or walking. Leg elevation during rest.
5. If you find that you legs swell up at the end of the day then venous hypertension is present and the condition will also benefit with the use of compression stockings worn daily,
All these are prescription drugs however barring vitamin C and should be discussed with your doctor. Other prescription options are drugs like Griseofulvin and light therapy with PUVA.
Please feel free to ask if you have any queries. I will be happy to continue further and do everything I can to provide you with the service you seek.