Stasis Dermatitis

What is stasis dermatitis?

Stasis dermatitis is a condition that affects the skin on your lower legs. Stasis dermatitis happens when certain medical conditions keep your blood from flowing well. The blood may pool in your lower legs because it does not pump back up to your heart correctly.

What increases my risk for stasis dermatitis?

Stasis dermatitis is more common in women and in people aged 50 years or older. Your risk is higher if someone in your family has the condition. The following problems may cause the blood to not flow well and may increase your risk:

• Heart problems.
  
  
• Obesity (when you weigh more than caregivers suggest).
  
  
• Pregnancy.
  
  
• Limited movement.

What are the signs and symptoms of stasis dermatitis?

You may not have any signs or symptoms of stasis dermatitis at first. Signs and symptoms may develop over time. You may first notice itching and redness on your inner ankles. You also may have any of the following:

• Your ankles and lower legs may swell. This may make it hard to move around.
  
  
• Your skin may turn bluish or develop brownish spots.
  
  
• You may get sores on your lower legs.
  
  
• Your leg veins may bulge (get hard and swollen).
  
  
• Your skin may feel rough, bumpy, thick, and scaly.
  
  
• You may have pain, heaviness, or warmth in your lower legs.

How is stasis dermatitis diagnosed?

Your caregiver will ask about your condition. Tell him about your signs and symptoms and how long you have had them. He may ask you what other medical conditions you have. He may ask if anyone in your family has had stasis dermatitis. Your caregiver will also do a physical exam. He may know you have stasis dermatitis by looking at your legs. You also may need tests to look for other health conditions. Ask your caregiver about these and other tests:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Doppler ultrasound and venous duplex imaging: These tests check the blood flow in your veins. Caregivers look for clots in the veins near the area of your pain and redness.
  
  
• Magnetic resonance imaging: This test is called an MRI. During the MRI, pictures are taken of your legs. An MRI may be used to look at your blood vessels. You will need to lie still during an MRI. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.
  
  
• Computed tomography scan: This is also called a CT scan. An x-ray machine uses a computer to take pictures of your legs to look at the blood vessels and to check for problems and abnormal changes. You may be given dye before the pictures are taken. The dye is usually given in an IV. The dye may help your caregivers see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish or have other allergies or medical conditions.
  
  
• Skin tissue biopsy: Caregivers may collect a sample of your skin. They will send the tissue to the lab for tests. Ask your caregiver for more information about skin tissue biopsy.

How is stasis dermatitis treated?

The goal of treatment is to decrease your signs and symptoms, such as swelling and itching. Unscented lotions or creams can help make your skin more moist. Treatment may decrease your chance of getting leg sores. A decrease in swelling may help with pain and may increase your ability to move around. You may need any of the following treatments:

• Rest and elevate: To decrease swelling, caregivers may have you elevate your legs above your heart. The easiest way to do this is to prop your legs on pillows while you are lying down. It is best to do this several times a day for 30 minutes each time. You may want to sleep with your legs propped on a pillow.
  
  
• Pressure stockings: These tight elastic stockings help keep blood from collecting in the legs and causing clots.
  
  
• Medicines: You may need any of the following medicines:
  
  
  • Anti-itching medicine: Caregivers may give you medicine to help keep your skin from itching. This medicine may be given in an IV, as a shot, by mouth, or as a skin lotion. Sometimes this medicine can make you sleepy.
    
    
  • Steroids: Steroid medicine may decrease redness, pain, and swelling. Steroid medicine for stasis dermatitis is normally given as a cream you put on your skin.
    
    
  • Medicines for pain or swelling: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease, a history of bleeding in your stomach, or any other medical problems.
    
    
  • Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.
  
  
• Surgery: You may need surgery to open your veins and help your blood move better.
  
  
• Treatment of open sores: You may need antibiotics if you have leg sores. Antibiotics may help treat or prevent an infection caused by germs called bacteria. Your caregiver may have you apply wet dressings to your leg sores. Dressings are bandages that help your leg sores heal. Change your dressings as often as your caregiver says you should. If you have open sores with dead tissue, your caregiver may want to remove the tissue. Ask for more information about procedures to remove dead tissue.

What are the risks of having and treating stasis dermatitis?

• You may have an allergic reaction to the medicine you use to treat stasis dermatitis. Steroid or antibiotic creams may cause more redness and swelling on your skin. Pressure stockings may limit your movement. Even with treatment, your skin may look bumpy or dark. Your signs and symptoms may not go away or may return.
  
  
• You may get a blood clot in your leg. A blood clot can cause pain and swelling. It can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• Without treatment, you can get sores on your legs. The sores may take a long time to heal and may cause scars. Sores and swelling may make it hard for you to move around. You may have trouble doing your normal daily activities, such as work or chores. Pain and limited movement may make you feel anxious or sad. Sores can become infected. Infection can enter your blood, which could be life-threatening. You may be at risk for skin cancer if your sores do not heal. Talk to your caregiver if you have any questions or concerns about your condition, treatment, or care.

How can I manage my stasis dermatitis?

• Do not scratch: Your symptoms may get worse if you scratch your sores. Scratching can also break open your skin and cause sores or lead to long-term damage.
  
  
• Maintain a healthy weight: By maintaining a healthy weight, you may help your blood flow more freely. If you are obese, talk with your caregiver about ways to help manage your weight.
  
  
• Eat a healthy diet: Eat a variety of healthy foods from all the food groups every day. Include whole-grain bread, cereal, rice, and pasta. Eat a variety of fruits and vegetables. Eat legumes (dry beans), and dark green and orange vegetables. Include dairy products, such as low-fat milk, yogurt, and cheese. Choose lean meat and poultry (chicken), fish, beans, eggs, and nuts. Ask your caregiver how many servings of fats, oils, and sweets you may have each day and if you need to be on a special diet.
  
  
• Exercise: Exercise makes the heart stronger and can help your blood flow better. It can help decrease your symptoms, such as pain and swelling. It is best to start exercising slowly and do more as you get stronger. Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you.
  
  
• Limit alcohol: Limit the amount of alcohol you drink. Drinking too much can damage your brain, heart, and liver. The risk of getting high blood pressure and certain types of cancer are greater for people who drink too much alcohol. Drinking too much alcohol also increases the risk of having a stroke. Women should limit alcohol to one drink a day. Men should limit alcohol to two drinks a day. A drink of alcohol is 12 ounces of beer, or five ounces of wine. One and one-half ounces of liquor, such as whiskey, is one drink of alcohol. If you drink alcohol, talk to your caregiver.
  
  
• Do not smoke: Smoking causes lung cancer and other long-term lung diseases. It increases your risk of many cancer types. Smoking also increases your risk of blood vessel disease, heart attack, and vision disorders. Not smoking may help prevent such symptoms as headaches and dizziness for yourself and those around you. Smokers have shorter lifespans than nonsmokers.

Where can I find more information?

Contact the following:

• American Academy of Dermatology
  P.O. Box 4014
  Schaumburg , IL 60168
  Phone: 1- 847 - 330-0230
  Phone: 1- 866 - 503-7546
  Web Address: http://www.aad.org/index.html
  

• National Institute of Arthritis and Musculoskeletal and Skin Disease
  Information Clearinghouse
  National Institutes of Health
  1 AMS Circle
  Bethesda , MD 20892-3675
  Phone: 1- 301 - 495-4484
  Phone: 1- 877 - 226-4267
  Web Address: http://www.niams.nih.gov
  

When should I call my caregiver?

Call your caregiver if:

• You have a fever.
  
  
• You have new or worse open sores.
  
  
• Your legs are painful to the touch. Your pain is not getting better, even with treatment.
  
  
• Your sores are draining pus.
  
  
• You have questions about any of your signs and symptoms.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your leg feels warm, tender, and painful. It may look swollen and red.
  
  
• You have chest pain or trouble breathing that is getting worse over time.
  
  
• You suddenly feel lightheaded and have trouble breathing.
  
  
• You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Stasis Dermatitis