Stasis Dermatitis
Aka: Stasis Dermatitis, Venous Dermatitis, Varicose Dermatitis, Varicose Eczema, Gravitational Eczema
II. Pathophysiology
- Venous Stasis changes related to Venous Insufficiency
III. 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)
- Results from subcutaneous fibrosis seen in Lipodermatosclerosis
IV. Management
- See Venous Insufficiency
- Avoid scratching and avoid other skin injury
- See Pruritus Management
- Apply Skin Lubricant (e.g. Vanicream) immediately after bathing and throughout the day
- Wrap legs (changed weekly, more for weaping lesions)
- Ace bandage compression or
- Una boot (4 layers wrapped with Coban or similar)
- Weaping lesions
- Dry weaping lesions with compresses of dilute vinegar on gauze
- Topical Corticosteroids (high potency)
- Apply to areas of closed, dry Stasis Dermatitis under wraps
V. Complications
- Venous Stasis Ulcer
- Cellulitis
- Recurrent Cellulitis predisposes to lymphatic insufficiency
- Eczematous Dermatitis
- Fat necrosis (sclerotic paniculitis)
- Inverted champagne bottle appearance to lower legs (bottle body) and ankles (bottle neck)