Stasis dermatitis refers to the

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...

changes that occur in the leg as a result of "stasis" or

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...

pooling from insufficient

venous Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...

return; the alternative name of varicose eczema comes from a common cause of this being

varicose vein Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indiv ...

s. Insufficient venous return results in increased pressure in the

capillaries A capillary is a small blood vessel from 5 to 10 micrometres (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: ...

with the result that both fluid and cells may "leak" out of the capillaries. This results in red cells breaking down, with iron containing

hemosiderin Hemosiderin image of a kidney viewed under a microscope. The brown areas represent hemosiderin Hemosiderin or haemosiderin is an iron-storage complex that is composed of partially digested ferritin and lysosomes. The breakdown of heme gives rise ...

possibly contributing to the

pathology Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...

of this entity.

Symptoms

Stasis dermatitis may be characterized by: * Skin that appears thin, brown and tissue-like, with possible skin lesions (

macule A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this sy ...

or patches), red spots, superficial skin irritation and/or darkening and/or thickening of the skin at the ankles or legs * Weak skin may ulcerate in some areas and legs, ankles, or other areas may become swollen * Open sores, ulcers * Itching and/or leg pains * Sometimes pain may persist from swollen tissues and may feel like "stabbing" or "needle pricks" If skin continues to deteriorate and breaks down, a

venous ulcer Venous ulcer is defined by the American Venous Forum as "a full-thickness defect of skin, most frequently in the ankle region, that fails to heal spontaneously and is sustained by chronic venous disease, based on venous duplex ultrasound testing." ...

(also known as a stasis ulcer) may form. Without proper wound care, open cracks predispose patients for the entry of a bacterial infection, causing

cellulitis Cellulitis is usually a bacterial infection involving the inner layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a few days. The borders of t ...

in the leg.

Diagnosis

Stasis dermatitis is diagnosed clinically by assessing the appearance of red plaques on the lower legs and the inner side of the ankle. Stasis dermatitis can resemble a number of other conditions, such as cellulitis and contact dermatitis, and at times needs the use of a duplex ultrasound to confirm the diagnosis or if clinical diagnosis alone is not sufficient.

Treatment

Treatment may consist of topical applications of steroid based creams and the use of

compression stockings Compression stockings (Flight Socks, Support Bandage) are a specialized hosiery designed to help prevent the occurrence of, and guard against further progression of, venous disorders such as edema, phlebitis and thrombosis. Compression stockings ...

intermittent pneumatic compression Intermittent pneumatic compression is a therapeutic technique used in medical devices that include an air pump and inflatable auxiliary sleeves, gloves or boots in a system designed to improve venous circulation in the limbs of patients who have ede ...

pumps, to help force the underlying buildup of fluids back out of the lower leg. Compression therapy should consist of moderate pressures and works best for ambulating patients. Ultimately, treating the underlying

venous reflux Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indi ...

is necessary to treat Stasis dermatitis. Invasive surgical procedures like saphenofemoral junction ligation with stripping were the norm for treatment in the past. However, less invasive methods are now more widely used. These newer methods include endovenous thermal ablation, ambulatory phlebotomy, and ultrasound foam sclerotherapy. File:Stasis dermatitis (Gravitational eczema).jpg, Stasis dermatitis (Gravitational eczema)

Complications

If stasis dermatitis goes untreated, the patient is at risk of developing venous ulcers and

Acroangiodermatitis Acroangiodermatitis of Mali is a rare cutaneous condition often characterized by purplish-blue to brown papules and plaques on the medial and lateral malleolus of both legs. Acroangiodermatitis is a rare skin condition characterised by hyperplas ...

References

External links