Stasis dermatitis and ulcers

Definition

Stasis dermatitis is a skin condition due to the build up of fluid (swelling) under the skin.

Alternative Names

Venous stasis ulcers; Ulcers - venous

Causes

The extra fluid that builds up in the body makes it hard for the blood to feed cells and get rid of 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.

As the skin becomes thin and inflamed, open ulcers may form and heal slowly. The skin may darken, and later become thick, perhaps due to excessive scratching of the area.

Poor circulation in the veins (venous insufficiency) can lead to stasis dermatitis and ulcers (craters) in the skin. Varicose veins, congestive heart failure, and other conditions can cause the arms and legs to swell, especially the feet and ankles.

Symptoms

• Swelling of legs, ankles, or other areas
• Skin appears thin, tissue-like
• Skin lesion: macule or patch
• Skin spots, red
• Darkening of skin at the ankles or legs
• Thickening of skin at the ankles or legs
• Open sores, ulcers 
• Superficial skin irritation of the legs
• Itching 
• Leg pains

Exams and Tests

The diagnosis is primarily based on the appearance of the skin. Your doctor may order tests to examine the blood flow in your legs.

Treatment

The underlying condition and swelling must be controlled. This may include surgical correction of varicose veins, medications to control heart failure, or diuretics to remove excess fluid.

Circulation in the area may improve as swelling is reduced. This can be aided by raising the legs above the level of the heart until the swelling goes down. Gradually increasing gentle activity, such as walking, can improve circulation.

Elastic stockings may be recommended to improve venous blood return from the legs, which will reduce swelling.

Treatment of the skin may include wet dressings and topical antibiotics to control infection in open ulcers.

The skin area should be kept clean and observed for signs of infection (pain, redness, drainage that looks like pus).

Outlook (Prognosis)

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

Possible Complications

• Secondary bacterial skin infections
• Permanent scar formation
• Chronic leg ulcers
• Infection of underlying bone

When to Contact a Medical Professional

Call for an appointment with your health care provider if leg swelling or stasis dermatitis develops.

Prevention

Prevention is the control of underlying causes of peripheral edema.

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