Stasis dermatitis is a fairly common inflammatory skin disease and appears on the lower limbs and is a sequela of chronic venous insufficiency.
It usually appears in middle-aged and elderly people and can lead to venous ulcers and hardening and discoloration changes of the skin (lipodermatosclerosis).
Why does venous insufficiency occur?
Chronic venous insufficiency is caused by a dysfunction of the valves that return blood along the deep venous system, often related to age. Due to venous insufficiency, there is an increase in venous tension in the lower limbs, resulting in inflammation or stasis dermatitis. The inflammation is caused by a decrease in oxygen to the area which can lead to skin damage and hardening of the skin.
Causes of stasis dermatitis
On many occasions, prior to dermatitis, edema appears in the legs due to increased fluid in the skin. There are risk factors for the appearance of edema such as congestive heart failure or arterial hypertension, and if they are treated they can cause a decrease in the probability of the appearance of dermatitis.
Symptoms of stasis dermatitis
At first, small lesions may appear on the surface of the skin with liquid content and cause it to have a shiny appearance, and later the rough, shallow scaly area is formed. In these phases the skin is red in color, but after a process of months or years the skin may change to a brown color, harden and an inverted champagne glass image called lipodermatosclerosis may be observed.
How do we diagnose dermatitis?
Complementary tests are not normally used to diagnose stasis dermatitis. The performance of a test such as Doppler ultrasound, to study the deep venous system, is of interest to rule out processes such as thrombosis.
Treatment
Treatment consists of reducing or limiting venous insufficiency with compression therapies. Such compression can be carried out with the use of compression stockings or more sophisticated methods such as boots specifically designed for such use. It is very important to transmit to the patient the importance of correct compression, since a high degree of non-compliance has been observed, which is one of the causes of the poor evolution of the process.
To control dermatitis or eczema, topical corticosteroids are used, whose potency and dosage regimen must be indicated by the specialist, who will study the risk-benefit balance and the most appropriate maintenance treatment.