Stasis Dermatitis

What is Stasis Dermatitis?

Dermatitis alone is a type of skin irritation with dry skin, itching, redness, and even erosions. Stasis is the swelling of the leg that are present in conditions of fluid buildup and poor circulation. Stasis dermatitis also known as venous eczema, gravitational dermatitis, or venous stasis dermatitis is the inflammation of the skin due to venous insufficiency where the blood pools in the veins of the legs.

Stasis Dermatitis back of legs

This condition is chronic and can be very uncomfortable. Individuals over 50 years have greater chances of developing the condition rather than those who are younger. Compared to men, there is a slight difference that women are more affected. This is thought to be caused by the stress on the leg veins due to pregnancy. Stasis dermatitis can occur in one or both legs and may rarely develop in other areas of the body.

What are the Symptoms of Stasis Dermatitis?

The first signs of stasis dermatitis are usually itching, reddening and dryness of the skin on the lower legs. Reddish-brown patches are also visible and it will appear shiny. The skin will become swollen or irritated and it will somewhat be painful upon standing or walking for a long time.

Varicose veins may also be present. As the condition progresses, the swelling scatters beyond the ankle up to the calf area; and other symptoms like a cracked skin, color of the open sores changes to violet, and oozing fluid, then the forming of scab or scars as they heal.

Severe cases of stasis dermatitis that can worsen over the years present some symptoms such as a very itchy skin that becomes pigmented, area feels hard, scaliness and redness covers the area, and the calf shrinks, making it appear like an upside-down wine bottle.

What Causes Stasis Dermatitis?

The veins inside the legs are one-way valves that are responsible for the blood to flow in the right direction directly towards the heart. The valves weaken as a person becomes older.

This will then allow blood to return back across the valves going to the feet and pool in the legs, instead of flowing towards the heart. Venous stasis results to stasis dermatitis.

Congestive failure of the heart and varicose veins can also cause the condition. Other causes that are linked with age are trauma, surgery, and deep vein thrombosis.

Types of Stasis Dermatitis

Stasis dermatitis can either be acute or chronic. Acute stasis dermatitis is distinguished by exudation, crusts, and superficial ulceration. Bandaging is essential to reduce swelling and tap water compresses must be applied.

Chronic stasis dermatitis can only be called chronic if it lasts for about 6 months or more, and if it constantly recurs. There is a slow progress of scarring and tightening of the skin resulting to hard and tender areas.

Diagnosis

The diagnosis for this condition is clinical according to the characteristic appearance of the lesions on the skin. The physician might order a venous Doppler ultrasound which is a noninvasive test that makes use of sound waves to examine the blood flow of the legs.

How is Stasis Dermatitis Treated?

The main goal of treating stasis dermatitis is to have it under control. Treatment plans will involve treating each of the signs and symptoms. These include:

  • Swelling – To reduce swelling, individuals use a compression dressing, Unna boot, or a compression stocking in order to lessen the swelling and improve the circulation. The elevation of the legs above the heart while asleep, and elevating once every two hours for about 15 minutes can also help.
  • Inflammation accompanied by redness and pain – To treat this, medicines like a topical calcineurin inhibitor or a corticosterioid may be prescribed by a dermatologist.
  • Wounds – A special dressing can be applied to the wound in order for it to heal.
  • Infection – If this is present, taking or applying an antibiotic to the affected area of stasis dermatitis can help clear the infection.
  • Dry skin – A moisturizer should be applied a few times per day to get rid of the dry skin. The moisturizer should have no perfumes, dyes, or fragrance since the condition makes the skin sensitive. Petroleum jelly can be used.
  • Itch – A very itchy sensation can be treated and calmed by antihistamine.
  • Varicose veins – Removing these veins can ease the discomfort. This is only appropriate when the dermatologist recommends it.
  • Skin discoloration – The condition can turn the skin to a brownish color. Visit a dermatologist for some treatment options to reduce the discoloration if it is already bothersome.

Prevention

To prevent stasis dermatitis, peripheral edema which is the swelling of the feet, legs, and ankles should be controlled.

ICD 9 Code

ICD 9 CM 454.1 is a medical billing code for reimbursement claims of patients with the diagnosis of stasis dermatitis or varicose veins of the lower extremities with an inflammation, with a service date on or before September 30, 2015. ICD 10 – CM is used for services rendered on or after October 1, 2015, which is the version 2015/16 ICD-10-CM I83.10.

Pictures

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Stasis Dermatitis on legs

Stasis Dermatitis photo

Stasis Dermatitis pic

Stasis Dermatitis picture

Stasis Dermatitis severe

References:

  • Stasis dermatitis – Symptoms, Causes, Treatment, Tips at https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q—t/stasis-dermatitis
  • http://www.healthline.com/health/stasis-dermatitis-and-ulcers#Overview1
  • http://www.skinsight.com/adult/stasisDermatitis.htm
  • Maroo N, Choudhury S, Sen S, Chatterjee S (2012 Jan). Oral doxycycline with topical tacrolimus for treatment of stasis dermatitis due to chronic venous insufficiency: A pilot study. Indian J Pharmacol. 44(1):111-3.
  • David CV, Chira S, Eells SJ, Ladrigan M, Papier A, Miller LG, et al (2011 Mar 15). Diagnostic accuracy in patients admitted to hospitals with cellulitis. Dermatol Online J. 17(3):1.
  • Pascarella L, Schonbein GW, Bergan JJ (2005 Nov. 19). Microcirculation and venous ulcers: a review. Ann Vasc Surg. (6):921-7.

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