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Stasis dermatitis: Diagnosis and treatment


How do dermatologists diagnose stasis dermatitis? 

To diagnose this condition, your dermatologist will examine your skin, looking closely at the skin that shows signs of stasis dermatitis. Your dermatologist will also want to know about your medical history. It is important to mention the following:

  • Past blood clot

  • Injury to the area

  • Heart disease

  • Surgeries

Medical tests may be necessary to find out exactly why you have poor circulation in the area. Your dermatologist may refer you to another doctor or recommend one or more of following tests:

  • Blood tests

  • Doppler ultrasound (to look at how your blood flows)

  • Tests to rule out problems with your heart

  • Allergy testing (stasis dermatitis increases the risk of developing an allergic reaction on your skin)

If you have stasis dermatitis, your dermatologist will create a treatment plan that addresses your specific needs.

How do dermatologists treat stasis dermatitis?

When treating stasis dermatitis, the goal is to get it under control. Your treatment plan will include treatment for each of your signs and symptoms, which may include:

Swelling: To reduce the swelling in a lower leg, most patients wear a compression stocking, compression dressing, or Unna boot. Compression can reduce swelling as well as improve your circulation.

Because it is so important to reduce swelling, it helps to elevate your legs throughout the day. If possible, dermatologists recommend that you elevate your legs above your heart:

  • Once every 2 hours for 15 minutes

  • While you sleep (keep your legs elevated with pillows)

Inflammation (redness, swelling, and pain): To treat this, most patients apply medicine to the stasis dermatitis. Your dermatologist may prescribe a medicine called a corticosteroid or a topical calcineurin (cal-see-neur-in) inhibitor (TCI).

Infection: If you have an infection, taking an antibiotic or applying an antibiotic to the stasis dermatitis can help clear the infection.

Wounds: You may need to apply a special dressing to the wound to help it heal.

Itch: Taking an antihistamine can help calm an intense itch.

Dry skin: Applying a moisturizer a few times per day can help get rid of the dry skin. 

Because stasis dermatitis makes the skin so sensitive, you’ll want to use a moisturizer that is free of:

  • Fragrance

  • Dyes

  • Perfumes

Good options include petroleum jelly and a thick cream that says “fragrance free” on the label. Your dermatologist may also recommend a moisturizer.

Varicose veins: Sometimes varicose veins — those large blue or purple veins that rise above the skin’s surface — can cause discomfort and pain. In rare cases, they can cause bleeding leg sores.

Removing troublesome vein can alleviate your discomfort and may reduce bleeding leg sores. If vein removal is recommended, your dermatologist can recommend an appropriate procedure for you. Many procedures are minimally invasive.

About the skin discoloration: Stasis dermatitis can cause the affected skin to turn a brownish color. This discoloration often remains even when the swelling, sores, and other signs clear. If the discoloration bothers you, ask your dermatologist about treatment options that could reduce the discoloration.

What is the outcome for a person who has stasis dermatitis?

You may have stasis dermatitis for life. Many patients are able to manage the disease on their own once they get the stasis dermatitis under control. Managing the disease often involves:

  • Wearing compression stockings

  • Elevating your legs as needed

  • Following a skin care plan

  • Applying medicine when you have a flare

You’ll also need to see your dermatologist for follow-up appointments.

Self-care plays an important role in getting stasis dermatitis under control. It is essential to keep it under control. 


References
Flugman, SL et al. (authors) and Elston DM et al. (editors). “Stasis dermatitis.” Medscape. Last updated July 2014.

Fritsch PO and Reider N. “Other eczematous eruptions. “Stasis dermatitis.” In: Bologna JL, Jorizzo JL, et. alDermatology (second edition), Elsevier Mosby, 2008:201-2.

Habif TP, Campbell JL, et al. “Stasis dermatitis” (card #18). Dermatology DDxDeck. Mosby Elsevier 2006.

Maroo N, Choudhury S, et. al. “Oral doxycycline with topical tacrolimus for treatment of stasis dermatitis due to chronic venous insufficiency: A pilot study.” Indian J Pharmacol. 2012 Jan-Feb;44(1):111-13.

Trayes KP, Studdiford JS, et. al. “Edema: Diagnosis and management.” Am Fam Physician. 2013 Jul 15;88(2):102-10.


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