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Dermatitis, stasis
What is Stasis Dermatitis?
Stasis Dermatitis is an eczemetous rash of the lower
extremities caused by venous stasis. Incompetence of venous valves causes
increased hydrostatic pressure resulting in capillary damage and leakage of
serum and red blood cells. This causes inflammation and an eczemetous rash in
some patients. The skin involved area exhibits brown hyperpigmentation due
to the pigment released from red blood cells, usually with underlying erythema.
The skin will usually be thickened and exhibit scaling. The medial malleolus
(inner ankle) is the most common site of involvement.
With what can it
be confused?
It can be confused with other forms of dermatitis,
especially contact dermatitis. Fungal
infections and bacterial cellulitis are also in the differential diagnosis.
How is it
diagnosed?
The diagnosis is usually made clinically. Patients
have a history of lower extremity edema that is followed by a chronic
eczemetous, pruritic rash. They may also report a history of thrombophlebitis,
and varicose veins are often noted. Petechiae are often present.
How is it treated?
The underlying condition, venous stasis, must be treated to
effect a cure. This is accomplished with compression stockings, limiting the
amount of standing, and weight-reduction when warranted. Bed rest with leg
elevation may be necessary if other measures fail. The rash can be treated with
a topical steroid and, if oozing or weeping astringent dressings (e.g.
Domeboro).
What is the prognosis?
If untreated, stasis dermatitis can progress to venous leg
ulceration. The disease is progressive, unless its course is arrested. The
involved skin is more prone to contact dermatitis than normal skin. Allergy to
topical medications, especially antibiotics when used, is common.
Date created:
04/06/2007
Last updated:
01/03/2009
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