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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 animal coverings, such as the arthropod exoskeleton, have different ...
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 is com ...
pooling from insufficient
venous Veins () are blood vessels in the circulatory system of 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 those of the pulmonary and fetal c ...
return; the alternative name of varicose eczema comes from a common cause of this being varicose veins. Insufficient venous return results in increased pressure in the
capillaries A capillary is a small blood vessel, from 5 to 10 micrometres in diameter, and is part of the microcirculation system. Capillaries are microvessels and the smallest blood vessels in the body. They are composed of only the tunica intima (the in ...
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 ri ...
possibly contributing to the
pathology Pathology is the study of disease. 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 the context of modern medical treatme ...
of this entity.


Symptoms

Stasis dermatitis may be characterized by: * Skin that appears thin, brown and tissue-like, with possible skin lesions ( macule 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 ...
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 or intermittent pneumatic compression 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 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 Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. Although usually just a cosmetic ailment, in some cases they cause fatigue, pain, itch, itching, and cramp, nighttime leg cram ...
, ambulatory phlebectomy, and ultrasound foam
sclerotherapy Sclerotherapy (the word reflects the Greek ''skleros'', meaning ''hard'') is a procedure used to treat blood vessel malformations ( vascular malformations) and also malformations of the lymphatic system. A medication is injected into the vessels ...
. 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.


See also

* Sinus pericranii *
List of cutaneous conditions Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the Human body, body and composed of Human skin, skin, hair, Nail (anatomy), nails, and related muscle and glands. The major function o ...


References


External links

{{DEFAULTSORT:Stasis Dermatitis Vascular-related cutaneous conditions