Stasis dermatitis (also called venous stasis dermatitis) is an inflammatory reaction seen in the skin of the lower
leg caused by static (slow or delayed) venous flow of the leg. Stasis
dermatitis is common
in patients 50 years and older. Factors that can
contribute to the early onset of stasis dermatitis include obesity, inactivity,
venous injury, dependency (lower than the heart) of the leg and infection of the
leg. The primary contributing cause of stasis dermatitis is valvular
incompentency of the veins of the leg resulting in chronic edema (swelling).
The appearance of venous stasis can range from simple swelling to severe
ulcerations (see symptoms, below).
Left untreated, venous stasis can progress to a venous ulceration. The
most common location for a venous ulceration of the lower extremity is over the
medial aspect of the ankle. Venous ulcerations vary in size and depth.
Treatment of stasis dermatitis and venous stasis ulcers.
Central to the treatment of venous stasis dermatitis and venous stasis ulcers
is control of lower extremity edema. Edema can be controlled by
elevating the legs above the level of the heart, use of diuretics and the use of
compression hose. It's important to
realize that when using compression hose, the hose need to be put on first thing
in the morning in advance of any swelling. If swelling is allowed to occur
before applying the support hose, that swelling will likely be there the rest of
Eczematous changes (peeling and flaking) and lichenification (hardening of
the epidermis) can be treated with
skin softening agents. Inflammatory changes of the skin are common and
can be treated with topical or oral steroids. Discoloration of the skin is
difficult to treat. Discoloration or darkening of the skin is often due to
the deposition of hemosiderin (the iron component of red blood cells).
Once hemosiderin is deposited in the skin, is is much like a tattoo that stains
the skin from within.
of the skin is common, particularly at the medial (inside) ankle. The area
superficial to the origin of the great saphenous vein is the most common site of
ulceration. Ulcerations should be cultured and treated for infection if
necessary. Dome paste boots, also called an Unna boots are the gold
standard for treating venous stasis ulcerations. Dome paste boot are
saturated with zinc oxide that will moisturize the skin. Dome past boots
are applied on a one weekly basis to control lower extremity edema.
Treatment can take from one to many weeks to see complete closure of the venous
ulcer. Negative pressure treatment of the wound along with skin grafting
may be necessary in severe, non-healing ulcers.
It is essential to realize that control of edema is necessary following
successful treatment of a venous stasis ulcer.
Compression hose should be worn daily to
prevent reoccurrence of ulcerations.
Dependency - this is the term used to describe the position the leg is in
while sitting. When positioned lower than the heart, the leg will swell.
Dependency is the position of the leg that would be considered the opposite of
elevating the leg.
Dermatitis - an inflammatory reaction of the skin. Dermatitis varies in
its' severity and cause.
Eczemification - early changes of the skin that include erythema (redness) and
peeling of the skin.
Indurated - firm thickening of the skin and subcutaneous tissues.
Lichenification - late changes that include thickening and scaling of the skin.
Stasis - static or non-flowing.
Venous - relating the the veins. Veins are the return loop of circulation
carrying blood towards the heart.
function of the venous system of the leg is to return blood from the foot back
to the heart. The lower extremity venous system consists of three types of
veins; superficial, perforator and deep veins. Veins are very similar to
arteries with the exception that veins have less muscle and must subsequently
carry a lower intra-luminal pressure. Most veins contain valves that
open with blood flow to the heart and close with a reversal of flow. The
purpose of the valves is to insure unidirectional flow of blood to the heart.
The veins of the leg are unique in that they also use muscular contraction to
drive blood to the heart. This pump is called the calf pump. While
walking, compression of the vein by the muscle helps to facilitate blood flow to
The two primary superficial veins of the leg are the great saphenous and the
small saphenous veins. While standing, the pressure in each of these veins
is equal to the pressure that would be found in a column of blood extending from
the foot to the heart. When the calf pump is activated, blood is pumped
proximally through the perforator veins into the deep veins. The deep
veins of the leg include the posterior tibial vein, anterior tibial vein,
popliteal vein and femoral vein.
No information is available for this topic.
The symptoms of stasis dermatitis vary with the general health of the
patient, duration of the condition and
status of treatment. Early stasis dermatitis shows a red blush surrounding the lower
1/3 of the leg. Stasis dermatitis is usually found in both legs with a
symmetrical presentation. Pigmentation changes (darkening) of the leg
usually follows a prolonged period of swelling (edema) of the lower leg.
the duration of edema continues, stasis dermatitis will worsen with
eczematization of the leg. Eczematization is the thickening of the skin
with lichenification. Lichenification describes crusting and layering of
the skin that occurs when the normal exfoliative properties of the skin are
disrupted by chronic swelling. In this stage of stasis dermatitis, oozing,
scaling and deep pigmentation changes in the skin may become apparent. The
skin and deeper tissues of the lower leg will also become indurated (firm).
If left untreated, stasis dermatitis will continue to the final stage where
the skin ulcerates due to the back pressure caused by venous incompentency.
In this stage, the leg will open and weep fluid. Infection may also become
a secondary issue due to a breach in the skin.
The differential diagnosis for this condition should include;
Products Recommended for Venous Stasis Dermatitis and Venous Ulcers:
|This article was written by Jeffrey A. Oster, DPM and last modified on 2/8/13. Additional references include;
Cutaneous Disorders of the Lower Extremities 2nd Edition., M H Samitz, MD.
J.P Lippincott Company, Philadelphia, 1981.
Was this information
Don't see the answer to your
question? Try one of these resources:
represents a wonderful opportunity to communicate and share information.
It's important to all of us at Myfootshop.com that we communicate in a way
that is most effective for the users of our site. Myfootshop.com follows the
online communication guidelines established by Medem, Inc.
At the conclusion of this article you'll find a number of products that are
recommended by Myfootshop.com to treat this condition. These products have
been hand picked by the medical consulting staff at Myfootshop.com for their
effectiveness and reliability. Should you have any questions regarding the
selection or use of these products please don't hesitate to contact us at
on this page does not constitute the practice of medicine and is offered as
an educational aid. Should you have a medical problem, Myfootshop.com
and their representatives recommend that you seek the help of your physician
or other healthcare professional.
Related Keywords and Search
venous stasis dermatitis