Stasis dermatitis

Stasis dermatitis

Definition:

Stasis dermatitis are skin changes caused by fluid build-up under the skin.

Causes, incidence, and risk factors:

Varicose veins, congestive heart failure, and other conditions can cause swelling of the extremities, especially the feet and ankles. This swelling (edema) is caused when plasma (the fluid portion of blood) leaks out of the blood vessels and into the tissues.

The excess fluid in the tissues interferes with the blood's ability to feed the tissue cells and dispose of cellular waste products. The tissue becomes poorly nourished and fragile, resulting in stasis dermatitis. The disorder is common on the ankles because there is less supportive tissue in this area.

In stasis dermatitis, the skin becomes thin and inflamed, and open ulcers may form and heal slowly. The skin may darken. The skin, initially thin, may later thicken, perhaps because of itching and scratching of the area.

Symptoms:

Swelling of legs, ankles, or other areas
Skin appears thin, tissue-like
Skin lesion: macule or patch
Skin spots, red
Darkening of skin at the ankles or legs
Thickening of skin at the ankles or legs
Open sores, ulcers (may develop)
Superficial skin irritation of the legs
Itching (of the affected area)
Leg pains (in the affected area)

Signs and tests:

The diagnosis is primarily based on the appearance of the skin. Your doctor may order tests to examine the blood flow in your legs.

Treatment:

The underlying condition and edema must be controlled. This may include surgical correction of varicose veins, medications to control heart failure, or diuretics to remove excess fluid.

Circulation in the area may be improved as edema is reduced. This can be aided by elevation of the legs above the level of the heart until swelling is lessened. Gradual increase in gentle activity, such as walking, can improve circulation.

Elastic stockings may be recommended to improve venous blood return from the legs, which will reduce swelling.

Treatment of the skin may include wet dressings and topical antibiotics to control infection in open ulcers.

The skin area should be kept clean and observed for signs of infection (pain, redness, drainage that looks like pus).

Expectations (prognosis):

Stasis dermatitis is often a chronic condition. Symptoms may be minimized if the underlying condition and edema can be controlled.

Complications:

Secondary bacterial skin infections
Permanent scar formation
Chronic leg ulcers
Infection of underlying bone

Calling your health care provider:

Call for an appointment with your health care provider if leg swelling or stasis dermatitis develops.

Prevention:

Prevention is the control of underlying causes of peripheral edema.

Review Date: 10/29/2001
Reviewed By: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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