Stasis Dermatitis


Introduction

Venous stasis dermatitis is an inflammation of the skin in the lower legs as a result of chronic venous insufficiency. Venous insufficiency occurs when veins and their valves are damaged and permit a backflow of blood, called venous reflux. When pooled venous blood collects in the legs, it can result in discoloration or changes in skin texture. Treatment for this condition focuses on treating the underlying condition and is usually successful. Lesions indicating venous stasis dermatitis first appear on the skin as red or brownish discolorations which may then begin to scale or crust and, if left untreated, to ulcerate.


Causes

Causes of Venous Stasis Dermatitis

Not everyone who suffers from venous insufficiency develops venous stasis dermatitis. For some patients, as blood pools in the veins of the lower leg, fluid leaks out of the veins into the skin and other tissues. This may lead to itching and changes in the color and texture of the skin.


Symptoms

Symptoms of Venous Stasis Dermatitis

Evidence of venous stasis dermatitis on the lower legs may include one or more of the following:

  • Thin, tissue-like texture of the skin
  • Brownish stains on the skin
  • Irritation or itching of the skin
  • Swollen legs or ankles
  • Thickening and hardening of the skin, called lipodermatosclerosis
  • Red, crusted or weepy skin
  • Cobblestone appearance of the skin

Symptoms of venous insufficiency, which precedes the development of venous stasis dermatitis, may include:

  • Dull aching or heaviness in the legs
  • Pain that gets worse upon standing
  • Swelling in the legs

Diagnosis

Diagnosis of Venous Stasis Dermatitis

This condition is usually diagnosed by physical examination, but other tests such as ultrasound may be employed to determine the extent of the precipitating vascular problem. Other tests may be performed to rule out any underlying cardiovascular disease.


Treatment

Treatment of Venous Stasis Dermatitis

In many cases, venous stasis dermatitis can be treated with simple methods which focus on the underlying condition of venous insufficiency. Such methods include avoiding long periods of sitting or standing in one place, elevating the legs whenever possible and wearing compression stockings. If these measures don’t result in healing, topical or oral antibiotics may be prescribed. Other lotions and creams, such as lanolin, calamine and benzocaine, are contraindicated since they may irritate skin that is already inflamed.

Venous stasis dermatitis can usually be resolved through noninvasive treatments, but sometimes minimally invasive surgical procedures are necessary, such as sclerotherapy, endovenous laser ablation or radiofrequency ablation.


Risks

Risks of Venous Stasis Dermatitis

Since venous stasis dermatitis is a chronic condition, it is important for it to be medically controlled. Left untreated, it can result in several complications which may include:

  • Bacterial skin infections
  • Chronic leg ulcers
  • Bone infections
  • Permanent scarring

It is important that patients with this condition be medically examined because the underlying venous insufficiency may be a sign of more serious vascular disease.

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