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Venous Stasis Dermatitis - Stasis Dermatitis


Overview, Causes, & Risk Factors

Stasis dermatitis is a red itchy rash on the lower legs. It occurs after long-term swelling of the lower leg, usually from poor blood circulation.

What is going on in the body?

Poor blood flow from the lower legs back to the heart causes swelling of the lower legs. Over time, this creates poor circulation in the skin of the legs. The skin begins to break into a rash, typically over the shins. It may eventually become weeping sores.

What are the causes and risks of the condition?

Stasis dermatitis is usually caused by poor blood flow from the veins of the legs back to the heart. It is seen most often in middle-aged people or people who are elderly. The poor blood flow may be associated with the following conditions:

  • varicose veins, which are bulging veins caused by damage to the valves within the veins
  • blood clots in the veins of the lower legs or pelvis
  • congestive heart failure, a condition in which a weakened heart is unable to pump blood effectively throughout the body
  • kidney failure
  • chronic leg swelling
  • The rash is often made worse by the use of salves or ointments. It may be aggravated by infection with bacteria or fungus.


    Symptoms & Signs

    What are the signs and symptoms of the condition?

    Stasis dermatitis causes a red, itchy rash on the lower legs. The rash can be dry and scaly or can weep and form crusts. The skin may turn to a brown or purple color, and the lower legs may swell.


    Diagnosis & Tests

    How is the condition diagnosed?

    A healthcare provider can diagnose stasis dermatitis with a medical history and physical examination.


    Prevention & Expectations

    What can be done to prevent the condition?

    The most important way to prevent stasis dermatitis is to avoid swelling of the legs over a long period of time. This can be done by exercising, wearing compression stockings to help blood circulation, and elevating the legs. Skin salves or ointments should not be used because they may further irritate skin that is already irritated.

    What are the long-term effects of the condition?

    Stasis dermatitis can lead to leg ulcers, which may be slow to heal because of the poor circulation to the area. The ulcers may infect deeper layers of tissue, also called cellulitis. Stasis dermatitis may also cause gross thickening of the skin of the lower leg, known as elephantiasis.

    What are the risks to others?

    Stasis dermatitis is not contagious and poses no risk to others.


    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment of stasis dermatitis includes the following:

  • cool compresses with a preparation known as Burow's solution, followed by application of plain petroleum jelly
  • topical hydrocortisone creams
  • compression of the leg with elastic bandage wraps, compression stockings, or a compression pump
  • antibiotic or antifungal medications if the skin is infected
  • What are the side effects of the treatments?

    Hydrocortisone creams may cause thinning and increased pigmentation of the skin with prolonged use.

    What happens after treatment for the condition?

    Stasis dermatitis should clear up with effective treatment. However, the discolored skin rarely returns to its normal color.

    How is the condition monitored?

    Any new or worsening symptoms should be reported to the healthcare provider.


    Attribution

    Author:Lynn West, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:02/28/01
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:07/27/01


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