This condition is commonly seen in patients with chronic venous insufficiency. Venous insufficiency occurs as a result of loss of valvular function. Stasis dermatitis typically affects middle-aged and elderly patients and may be a precursor to lower leg venous ulcers.
History/Physical:
- The appearance of reddish-brown skin may represent an early sign of stasis dermatitis
- Stasis dermatitis is associated with brown deposits in the skin called hemosiderin
- The inner ankle is frequently involved
- Lower extremity edema (swelling) is often present
- The patient with stasis dermatitis may experience mild itching, pain, or even cramping
- Stasis dermatitis may present as red, scaling plaques with drainage, crusting, and possible superficial ulceration
Differential diagnosis:
- Eczema - A skin condition that may include dryness, rash, and inflammation
- Dermatitis (various types)
- Cellulitis - A skin infection
- Necrobiosis Lipoidica - A necrotizing skin condition
- Tinea Pedis - An infection of the skin caused by a fungus
Work-up:
- Venous doppler study may be used to reveal a deep venous thrombosis or valve damage
- Skin biopsy of stasis dermatitis may be indicated in rare instances.
Treatment:
- Compression therapy - Specialized compression stockings that have a controlled gradient of pressure. Compression can also be accomplished by the use of elastic wraps and Unna boots.
- Elevation of lower extremities frequently
Topicals:
- Corticosteroids - To reduce inflammation and itching
- Wet to damp gauze dressings for weeping lesions
- Open lesions are treated with topical antibiotics
- Leg ulcerations or lesions with with coexisting skin infections may also be treated with oral or IV antibiotics by the physician
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