Stasis dermatitis and ulcers
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Definition
Stasis dermatitis is a change in the skin that occur when blood collects (pools) in the veins of the lower leg.
Alternative Names
Venous stasis ulcers; Ulcers - venous; Venous ulcer
Causes, incidence, and risk factors
Venous insufficiency is a long-term (chronic) condition in which the veins have problems sending blood from the legs back to the heart.
Some people with venous insufficiency develop stasis dermatitis. Blood pools in the veins of the lower leg. Fluid and blood cells leak out of the veins into the skin and other tissues. This may lead to itching, which causes more skin changes.
Symptoms
You may have symptoms of venous insufficiency including:
- Dull aching or heaviness in the leg
- Pain that gets worse when you stand
- Swelling in the leg
At first, the skin of the ankles and lower legs may look thin or tissue-like. You may slowly get brown stains on the skin.
The skin may become irritated or crack if you scratch it. It may also become red or swollen, crusted, or weepy.
Over time, some skin changes become permanent:
- Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
- A bumpy or cobblestone appearance of the skin
- Dark brown color
Skin sores (ulcers) may develop (called a venous ulcer or stasis ulcer). These most often form on the inside of the ankle.
Signs and tests
The diagnosis is primarily based on the appearance of the skin. Your doctor may order tests to examine the blood flow in your legs.
Stasis dermatitis can be related to heart problems so you may need test to check your heart function.
Treatment
You may take the following steps to manage venous insufficiency, which is causing stasis dermatitis:
- Use elastic or compression stockings to reduce swelling
- Avoid standing or sitting for long periods
- Keep your leg raised when you sit
- Try varicose vein stripping or other nonsurgical procedures
Some skin care treatments can make the problem worse. Talk with your health care provider before using any lotions, creams, or antibiotic ointments.
Things to avoid:
- Topical antibiotics, such as neomycin
- Drying lotions, such as calamine
- Lanolin
- Benzocaine and other products meant to numb the skin
Treatments your health care provider may suggest include:
- Wet dressings (use only when instructed)
- Topical steroid creams or ointments
- Oral antibiotics
Expectations (prognosis)
Stasis dermatitis is often a long-term (chronic) condition.
Complications
- Bacterial skin infections
- Chronic leg ulcers
- Infection of bone
- Permanent scar
Calling your health care provider
Call your health care provider if you develop leg swelling or symptoms of stasis dermatitis.
Watch for signs of infection such as:
- Drainage that looks like pus
- Open skin sores (ulcers)
- Pain
- Redness
Prevention
To prevent this condition, control the causes of peripheral edema.
References
Reider N, Fritsch PO. Other Eczematous Eruptions. In:Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 13.