Stasis Dermatitis

Stasis dermatitis refers to a skin change that appears on the leg as a consequence of a “pooling” of blood due to the “stasis” caused by venous insufficiency. This skin condition is also commonly referred to as Varicose eczema based on its origin in Varicose vein disease.

The presence of a medical condition referred to as Chronic venous insufficiency or Varicose vein disease, results from a progressive breakdown in the valves found within the lumen of veins. The result of such a breakdown is a gradual increase in the level of blood flow congestion and pressure within the effected veins. This increase in pressure and congestion within the venous circulation inevitably gives rise to an increase in capillary pressure.  It is this increase in congestion and pressure that will over time force blood fluid to extravasate out into the interstitial tissue of the dermis (skin). The end result is a patch of eczema or a dermatitis type rash that manifests itself at the skin level.

Symptoms

  • The skin will take on a reddish-brown appearance with an occasionally patchy appearance. The tissue will often times have an irritated look to it. When present for an extended period of time, the surrounding tissue often becomes thickened and tougher especially in and around the distal leg and ankle region.
  • Open sores or venous stasis ulcers
  • Swollen legs, ankles, or other areas typically below knee level
  • Itching and/or leg pains
  • Numbness or tingling in the affected areas or below

The stasis dermatitis when present for extended periods, may predispose the region to bacterial entry and the potential for a localized cellulitis (skin infection). The risk in developing a cellulitis increases when the stasis dermatitis occurs in conjunction with a peripheral arterial insufficiency. On occasion, the dermatitis can deteriorate further to give rise to a venous ulcer or stasis ulcer.

Treatment

The choice of treatment typically depends on the underlying etiology of the stasis dermatitis. In the majority of cases, chronic venous insufficiency or varicose vein disease is the driving force behind the formation of the stasis dermatitis. Addressing the underlying vein disease issues and correcting the venous circulation will eliminate the dermatitis and promote healing and resolution of any venous stasis ulcers that may be present. The use of compression stockings or non-elastic compression devices as a primary treatment option can be successful in resolving the dermatitis or venous ulcer but are not long-term solutions for the underlying vein disease issues.

In the majority of cases, despite the resolution of the dermatitis and/or stasis ulcer, clinical history suggests that people will ultimately see a recurrence of their dermatitis or stasis ulcer over time due to the fact that the underlying venous disease was never treated.  The use of topical steroid based creams may prove beneficial in helping to address the immediate underlying inflammation typically seen in the affected areas. Unfortunately, as in the case of compression stockings and non-elastic compression, these creams also do not address the underlying venous disease problem that is causing the dermatitis problem from the beginning. This is why such creams have also not been found to be successful long-term treatment options.

Individuals who are experiencing venous stasis dermatitis or venous ulceration issues, should first and foremost obtain an immediate consultation with a phlebologist (a physician specializing in the treatment of vein disease). Should you have this issue, don’t wait to call STL Vein & Cosmetics at 314.842.1441 for a consultation today.

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