STASIS DERMATITIS                                                                        

Stasis dermatitis is characterized by scaly, greasy looking skin on the lower legs and around the ankles. Stasis dermatitis is most apt to affect the inner side of the calf and is generally related to circulatory problems

This type often occurs with varicose veins. Stasis dermatitis may cause the skin at your ankles and over your shins to become discolored (red or brown), thick and itchy. Stasis dermatitis can occur when fluid accumulates in the tissues just beneath your skin. Varicose veins and other chronic conditions in your legs can cause the fluid buildup. 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.

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

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.

Elevating the ankle above the heart while resting (to increase venous return and prevent tissue swelling), wearing properly fitted support hose, and applying topical therapy are necessary. However, unless circulation improves, these approaches will be relatively ineffective. The choice of topical therapy depends on the disease stage. For acute stasis dermatitis, continuous and then intermittent tap-water compresses should be applied. For an exudative lesion, a more absorbent hydrocolloid dressing may be the best treatment. For less acute dermatitis, a corticosteroid cream or ointment may be prescribed or incorporated into zinc oxide paste.

Oral antibiotics are useful when cellulitis is present; topical antibiotics are useless and often cause contact dermatitis.

Complex or multiple topical drugs or nonprescription remedies should not be used: The skin in stasis dermatitis is more vulnerable to direct irritants and to potentially sensitizing topical agents (antibiotics; anesthetics; vehicles of topical drugs, especially lanolin or wool alcohols).

Involved skin in stasis dermatitis may exhibit the same changes as seen in other eczema conditions. Severe, acute inflammation may result in exudative, weeping patches and plaques. Secondary infection can cause typical honey-colored crusting due to bacteria, or monomorphous pustules due to cutaneous candidiasis. In long-standing lesions, lichenification and hyperpigmentation may occur as a consequence of chronic scratching and rubbing.

In addition to lichenification and hyperpigmentation, chronic stasis dermatitis can show changes such as skin induration, which may progress to lipodermatosclerosis with the classic "inverted champagne bottle" appearance. Another unique feature sometimes seen in chronic stasis dermatitis is the development of violaceous plaques and nodules on the legs and dorsal feet. These lesions frequently undergo painful ulceration and can be clinically indistinguishable from classic Kaposi sarcoma. This clinical appearance has led this entity to be called "pseudoKaposi sarcoma" or acroangiodermatitis.

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.

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

Complications include:

  • Secondary bacterial skin infections

  • Permanent scar formation

  • Chronic leg ulcers

  • Infection of underlying bone

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


In this International Eczema-Psoriasis Foundation website, you will find information about eczema, psoriasis, dermatitis, seborrheic dermatitis, contact dermatitis, atopic dermatitis, perioral dermatitis, guttate psoriasis, their symptoms, causes and treatments. You will be able to distinguish between eczema and similar conditions such as contact dermatitis, atopic dermatitis, stasis dermatitis, seborrheic dermatitis, neurodermatitis, contact eczema, light sensitive eczema, juvenile plantar eczema, eczema craquele, eczema herpeticum, atopic eczema, infantile eczema, adult seborrheic eczema, varicose eczema, discoid eczema, dyshidrotic eczema, palmoplantar psoriasis, plaque psoriasis, guttate psoriasis, inverse psoriasis, erythrodermic psoriasis, pustular psoriasis, psoriatic arthritis, scalp & ear psoriasis, and nail psoriasis. Treatment, symptoms and medications used in the treatment of eczema, dermatitis, psoriasis and skin conditions that co-exist with dermatitis, such as adult acne, lupus, and rosacea will be presented. The informative text on eczema, dermatitis and psoriasis discusses treatment, causes, and lifestyle changes that help treat dermatitis, eczema, and psoriasis.

Here are some other websites dealing with skin diseases:
The Acne Group
International Rosacea Foundation
Acne
Cellulite
Dermatitis
Rosacea
Rosacea Advantages
Rosacea Flushing
Rosacea Lifestyles