Stasis dermatitis - Misplaced Pages

(Redirected from Venous eczema) Skin changes in the leg due to blood pooling Medical condition

Stasis dermatitis
Other names	congestion eczema, gravitational dermatitis, gravitational eczema, stasis eczema, varicose eczema
Specialty	Dermatology

Stasis dermatitis refers to the skin changes that occur in the leg as a result of "stasis" or blood pooling from insufficient venous return; the alternative name of varicose eczema comes from a common cause of this being varicose veins.

Insufficient venous return results in increased pressure in the capillaries with the result that both fluid and cells may "leak" out of the capillaries. This results in red cells breaking down, with iron containing hemosiderin possibly contributing to the pathology of this entity.

Symptoms

Stasis dermatitis may be characterized by:

Skin that appears thin, brown and tissue-like, with possible skin lesions (macule or patches), red spots, superficial skin irritation and/or darkening and/or thickening of the skin at the ankles or legs
Weak skin may ulcerate in some areas and legs, ankles, or other areas may become swollen
Open sores, ulcers
Itching and/or leg pains
Sometimes pain may persist from swollen tissues and may feel like "stabbing" or "needle pricks"

If skin continues to deteriorate and breaks down, a venous ulcer (also known as a stasis ulcer) may form. Without proper wound care, open cracks predispose patients for the entry of a bacterial infection, causing cellulitis in the leg.

Diagnosis

Stasis dermatitis is diagnosed clinically by assessing the appearance of red plaques on the lower legs and the inner side of the ankle. Stasis dermatitis can resemble a number of other conditions, such as cellulitis and contact dermatitis, and at times needs the use of a duplex ultrasound to confirm the diagnosis or if clinical diagnosis alone is not sufficient.

Treatment

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Treatment may consist of topical applications of steroid based creams and the use of compression stockings or intermittent pneumatic compression pumps, to help force the underlying buildup of fluids back out of the lower leg.

Compression therapy should consist of moderate pressures and works best for ambulating patients.

Ultimately, treating the underlying venous reflux is necessary to treat Stasis dermatitis. Invasive surgical procedures like saphenofemoral junction ligation with stripping were the norm for treatment in the past. However, less invasive methods are now more widely used. These newer methods include endovenous thermal ablation, ambulatory phlebotomy, and ultrasound foam sclerotherapy.

Stasis dermatitis (Gravitational eczema)

Complications

If stasis dermatitis goes untreated, the patient is at risk of developing venous ulcers and Acroangiodermatitis.

References

Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. Chapter 14. ISBN 978-1-4160-2999-1.
"Stasis dermatitis and ulcers: Causes, symptoms, and treatment". Medical News Today. Retrieved 2018-08-30.
^ "Stasis dermatitis and ulcers". United States National Institute of Health. Retrieved July 31, 2008.
Trayes, Kathryn P.; Studdiford, James; Pickle, Sarah; Tully, Amber S. (2013-07-15). "Edema: Diagnosis and Management". American Family Physician. 88 (2): 102–110. ISSN 0002-838X. PMID 23939641.
^ Sundaresan, Swaminathan; Migden, Michael R.; Silapunt, Sirunya (June 2017). "Stasis Dermatitis: Pathophysiology, Evaluation, and Management". American Journal of Clinical Dermatology. 18 (3): 383–390. doi:10.1007/s40257-016-0250-0. ISSN 1179-1888. PMID 28063094. S2CID 3624955.
^ Manchanda, Kajal; Singh, SatyendraKumar (2014). "Acroangiodermatitis (Pseudo-Kaposi sarcoma)". Indian Dermatology Online Journal. 5 (3): 323–325. doi:10.4103/2229-5178.137791. ISSN 2229-5178. PMC 4144224. PMID 25165656.

External links

Classification	D ICD-10: I83.1 ICD-9-CM: 459.81
External resources	eMedicine: article/1084813

Cardiovascular disease (vessels)

Arteries, arterioles
and capillaries

Inflammation	Arteritis Aortitis Buerger's disease
Arteriosclerosis	Atherosclerosis Foam cell Fatty streak Atheroma Cholesterol LDL Oxycholesterol Trans fat Monckeberg's arteriosclerosis Hyaline arteriolosclerosis Hyperplastic arteriolosclerosis
Peripheral artery disease	Stenosis Carotid artery stenosis Renal artery stenosis Aortoiliac occlusive disease Critical limb ischemia Degos disease Erythromelalgia Fibromuscular dysplasia Hepatic artery thrombosis Intermittent claudication Raynaud's phenomenon
Aneurysm / dissection / pseudoaneurysm	torso: Aortic aneurysm Abdominal aortic aneurysm Thoracic aortic aneurysm Aneurysm of sinus of Valsalva Aortic dissection Aortic rupture Coronary artery aneurysm head / neck Intracranial aneurysm Intracranial berry aneurysm Carotid artery dissection Vertebral artery dissection Familial aortic dissection
Vascular malformation	Arteriovenous fistula Arteriovenous malformation Telangiectasia Hereditary hemorrhagic telangiectasia Generalized essential telangiectasia
Vascular nevus	Cherry hemangioma Halo nevus Spider angioma

Veins

Inflammation	Phlebitis
Venous thrombosis / Thrombophlebitis	primarily lower limb Deep vein thrombosis abdomen Hepatic veno-occlusive disease Budd–Chiari syndrome May–Thurner syndrome Portal vein thrombosis Renal vein thrombosis upper limb / torso Mondor's disease Paget–Schroetter disease Pulmonary embolism head Cerebral venous sinus thrombosis Post-thrombotic syndrome
Varicose veins	Gastric varices Portacaval anastomosis Caput medusae Esophageal varices Hemorrhoid Varicocele
Other	Chronic venous insufficiency Chronic cerebrospinal venous insufficiency Superior vena cava syndrome Inferior vena cava syndrome Venous ulcer

Arteries or veins

Blood pressure

Hypertension	Hypertensive heart disease Hypertensive emergency Hypertensive nephropathy Essential hypertension Secondary hypertension Renovascular hypertension Benign hypertension Pulmonary hypertension Systolic hypertension White coat hypertension
Hypotension	Orthostatic hypotension Shock (circulatory)

Diseases of the skin and appendages by morphology

Growths

Epidermal	Wart Callus Seborrheic keratosis Acrochordon Molluscum contagiosum Actinic keratosis Squamous-cell carcinoma Basal-cell carcinoma Merkel-cell carcinoma Nevus sebaceous Trichoepithelioma
Pigmented	Freckles Lentigo Melasma Nevus Melanoma
Dermal and subcutaneous	Epidermal inclusion cyst Hemangioma Dermatofibroma (benign fibrous histiocytoma) Keloid Lipoma Neurofibroma Xanthoma Kaposi's sarcoma Infantile digital fibromatosis Granular cell tumor Leiomyoma Lymphangioma circumscriptum Myxoid cyst

Rashes

With
epidermal
involvement

Eczematous	Contact dermatitis Atopic dermatitis Seborrheic dermatitis Stasis dermatitis Lichen simplex chronicus Darier's disease Glucagonoma syndrome Langerhans cell histiocytosis Lichen sclerosus Pemphigus foliaceus Wiskott–Aldrich syndrome Zinc deficiency
Scaling	Psoriasis Tinea (Corporis Cruris Pedis Manuum Faciei) Pityriasis rosea Secondary syphilis Mycosis fungoides Systemic lupus erythematosus Pityriasis rubra pilaris Parapsoriasis Ichthyosis
Blistering	Herpes simplex Herpes zoster Varicella Bullous impetigo Acute contact dermatitis Pemphigus vulgaris Bullous pemphigoid Dermatitis herpetiformis Porphyria cutanea tarda Epidermolysis bullosa simplex
Papular	Scabies Insect bite reactions Lichen planus Miliaria Keratosis pilaris Lichen spinulosus Transient acantholytic dermatosis Lichen nitidus Pityriasis lichenoides et varioliformis acuta
Pustular	Acne vulgaris Rosacea Folliculitis Impetigo Candidiasis Gonococcemia Dermatophyte Coccidioidomycosis Subcorneal pustular dermatosis
Hypopigmented	Tinea versicolor Vitiligo Pityriasis alba Postinflammatory hyperpigmentation Tuberous sclerosis Idiopathic guttate hypomelanosis Leprosy Hypopigmented mycosis fungoides

Without
epidermal
involvement

Red

Blanchable
Erythema

Generalized	Drug eruptions Viral exanthems Toxic erythema Systemic lupus erythematosus
Localized	Cellulitis Abscess Boil Erythema nodosum Carcinoid syndrome Fixed drug eruption
Specialized	Urticaria Erythema (Multiforme Migrans Gyratum repens Annulare centrifugum Ab igne)

Nonblanchable
Purpura

Macular	Thrombocytopenic purpura Actinic/solar purpura
Papular	Disseminated intravascular coagulation Vasculitis

Indurated

Miscellaneous
disorders

Ulcers
Hair	Telogen effluvium Androgenic alopecia Alopecia areata Systemic lupus erythematosus Tinea capitis Loose anagen syndrome Lichen planopilaris Folliculitis decalvans Acne keloidalis nuchae
Nail	Onychomycosis Psoriasis Paronychia Ingrown nail
Mucous membrane	Aphthous stomatitis Oral candidiasis Lichen planus Leukoplakia Pemphigus vulgaris Mucous membrane pemphigoid Cicatricial pemphigoid Herpesvirus Coxsackievirus Syphilis Systemic histoplasmosis Squamous-cell carcinoma

Category:

Vascular-related cutaneous conditions