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stasis dermatitis

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Stasis dermatitis

Alternative Names
venous stasis dermatitis

Definition
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. It may be dry and scaly or weeping and crusted. Often the skin is a brownish colour.

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 out into a rash, typically above the inside aspect of the ankles. It may eventually break down into weeping sores and ulcers.

What are the signs and symptoms of the condition?
Stasis dermatitis can cause:
  • swollen lower legs
  • rash on the shins, ankles, and sometimes the entire lower leg
  • weeping of clear yellowish fluid that dries into crusts
  • brown or purplish coloured skin
  • itching and burning
  • ulcers
What are the causes and risks of the condition?
Common causes of stasis dermatitis include: It may be aggravated by infection with bacteria or fungus.

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.

How is the condition diagnosed?
This condition is diagnosed by examination of the skin.

What are the long-term effects of the condition?
Long-term effects can include:
  • leg ulcers in persons with long-standing untreated stasis dermatitis
  • gross thickening of the skin of the lower leg and swelling of the soft tissue. This is known as elephantiasis.
What are the risks to others?
Stasis ulcers are not contagious.

What are the treatments for the condition?
Treatment of stasis ulcers includes:
  • cool compresses with antiseptic preparations, followed by application of plain petroleum jelly
  • topical hydrocortisone cream
  • compression of the leg with elastic bandage wraps, compression stockings, or a compression pump along with leg elevation
  • antibiotic or antifungal therapy if the skin is infected
What are the side effects of the treatments?
  • Standard treatment has minimal side effects. Hydrocortisone creams may cause thinning and increased pigmentation of the skin with prolonged use.
What happens after treatment for the condition?
Nearly complete or complete clearing of the stasis dermatitis should be expected. The discoloured skin rarely returns to normal.

How is the condition monitored?
The preventive measures must be followed (e.g. compression stockings). If the rash flares up, it should be treated again promptly.

Author: Lynn West, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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