Derm

Stasis Dermatitis

Stasis Dermatitis, Venous Dermatitis, Varicose Dermatitis, Varicose Eczema, Gravitational Eczema, Venous Stasis Dermatitis, Venous Stasis Hyperpigmentation

See also

Pathophysiology

See Venous Insufficiency
Venous Stasis changes related to Venous Insufficiency

Epidemiology

Prevalence: 2 to 6 million have advanced Venous Insufficiency in U.S. (500,000 with Venous Stasis Ulcers)

Signs

Venous Insufficiency changes
Erythematous Plaque
Fine fissures
Scaling
Hyperpigmentation with pinpoint brown Macules (Hemosiderin deposits)
Stasis changes on legs and foot dorsum
Secondary changes with scarring and skin atrophy
Telangiectasias
Corona Phlebectatica (abnormally dilated veins at the ankle and foot)
Atrophie blanche (atrophic white scarring)
Lipodermatosclerosis
Narrowing of the distal lower leg (similar to an inverted champagne bottle)
1. Results from subcutaneous fibrosis seen in Lipodermatosclerosis

Management

See Venous Insufficiency
Avoid scratching and avoid other Skin Injury
1. See Pruritus Management
2. Apply Skin Lubricant (e.g. Vanicream) immediately after bathing and throughout the day
Wrap legs (changed weekly, more for weaping lesions)
1. Ace bandage compression or
2. Una boot (4 layers wrapped with Coban or similar)
Weaping lesions
1. Dry weaping lesions with compresses of dilute vinegar on gauze
Topical Corticosteroids (high potency)
1. Apply to areas of closed, dry Stasis Dermatitis under wraps

Complications

Venous Stasis Ulcer
Cellulitis
1. Recurrent Cellulitis predisposes to lymphatic insufficiency
Eczematous Dermatitis
Fat necrosis (sclerotic paniculitis)
1. Inverted champagne bottle appearance to lower legs (bottle body) and ankles (bottle neck)

References