Stasis Dermatitis Pictures
What is Stasis Dermatitis?
Stasis dermatitis is also known as varicose eczema, gravitational dermatitis or gravitational eczema. It is characterized by an inflammation of the skin that resulted from the accumulation of the blood in the veins and tissues of the lower extremities.
Stasis dermatitis is prevalent in older people particularly those above the age of 50 years. It rarely occurs in people under the age of 40 and the incidence is more common in women than in men. This inflammatory condition is known to affect older people all over the world without racial predilection. It is neither a serious nor a life-threatening condition but stasis dermatitis can cause a lot of discomfort to the patient.
The vein is a membranous tube or elastic blood vessels that carry blood from different parts or organs of the body towards the heart. The size of the vein varies and ranges from 1mm to 1 to 1.5 cm in diameter and is categorized into four namely pulmonary, systemic, superficial and deep veins. The deep vein is greatly involved in the process of the stasis dermatitis. It is a type of vein that is situated within the tissue of the muscles and can be found near analogous artery. The vein also consists of three layers with the "tunica adventitia" as the outer layer of the vein which is a strong covering of the arteries and the veins. This layer of the vein allows expansion to accommodate the impact of pressure exerted during the blood flow. The tunica media is the middle layer of the veins and the arteries. The arteries have a thicker layer of tunica media as compared to the veins and this layer is also composed of elastic fibers and smooth muscles. The inner layer of the veins and the arteries is called the "tunica intima". Elastic membrane lining and smooth endothelium covered by elastic tissues are composed in the arteries while the veins do not have the elastic membrane.
The onset of stasis dermatitis can occur gradually that it may develop unnoticeably or it may also occur rapidly like it may develop overnight. Depending on the manner of onset, stasis dermatitis have various symptoms that may be experienced differently from one person to another depending on the cause or the underlying condition influencing the development and the overall health status of an affected individual.
The early stage of stasis dermatitis is exhibited by a thinning of the skin in the lower extremities or the legs. The skin thinning of the legs will eventually lead to itching while the impulse and need to scratch the itchy area can later result to the formation of cracks in the skin which may be associated with fluid leaking out of the skin surface. This process will bring changes to the skin over a period of time or during the process of stasis dermatitis.
Common signs and symptoms of stasis dermatitis:
- Either one or both legs may exhibit swelling while it can include either one or both of the feet with swelling extending to just beneath the knee in severe cases of stasis dermatitis.
- Pain in one or both legs is exhibited
- Skin thinning of the affected leg
- Inflammation of the affected leg
- Itching of the inflamed section which may become severe.
- Painful skin lesions that are gradual in healing and is the result of an incessant scratching.
- Development of skin patches that may appear dry and scaly and may ooze with fluid.
- Reddish brown discoloration of the skin over the affected area.
- Skin crusting may occur if the lesions have become infected.
- Violet discoloration of lesion on top of the legs and the feet.
The onset of cracks in the skin of the affected area will give way for the bacteria to set in and start on the infection. The infection may be accompanied by symptoms of high grade fever and pain over the affected area. The pain may be described as stabbing or pricking.
Blood pooling in the veins of the legs is the cause of stasis dermatitis. The insufficiency in the circulation influences the increase in pressure of higher than the normal pressure within the veins. The elevation in the venous pressure is potential for damage in the capillaries that can lead to its breakout and secretion of fluid or fibrinogen into tissues. The accumulation of the fibrinogen will later turn into fibrin which in turn can obstruct the blood flow causing oxygen insufficiency and later cell death. The inflammation and changes in the skin appearance are the consequence of cell death that occurred due to the insufficiency in the circulation.
Age advancement is among the risk factor and the most common cause of stasis dermatitis. The veins gradually lose elasticity as an individual advances in age which is part of the normal aging process. The rigidity in the veins increases the pressure within which can later on lead to rupture in the veins and damages to capillaries.
Pregnancy is also believed to contribute to the onset of stasis dermatitis. This explains the high prevalence among women as compared to men. The etiology is implicated on the increasing weight of the developing fetus which the mother is carrying. This in turn increases the pressure on the lower extremities that bears the weight and the increasing weight of both the mother and the developing fetus.
Other causes of stasis dermatitis include the following:
- Deep vein thrombosis
- A surgical procedure that can damage the veins in the lower legs.
- Injury in any form that can directly damage the veins in the lower legs.
The initial step in diagnosing stasis dermatitis is through the complete medical history of the patient to give a background and a clear view of the condition. Physical examination is also among the initial step by carefully examining the presentation of the affected leg or both legs.
The blood test is also considered in evaluating this type of dermatitis to identify the infection and isolate the skin dermatitis. Doppler testing may also be recommended to measure and evaluate the degree of blood flow into the veins of the lower extremities.
Stasis dermatitis has no direct cure or treatment. The goal of management is towards the relief of symptoms and lessening the clinical impact of venous insufficiency. The treatment and management may include the following:
- Compression therapy is especially prescribed to the patient through wearing compression stocking to control the pressure of the affected leg or legs and improve its circulation
- Topical steroid application in low dose is given to reduce the inflammation of the affected area
- Topical antibiotics are recommended for stasis dermatitis associated with infection
- Elevation of the affected leg or legs is advisable to improve the circulation while reducing the inflammation
It is not advisable to take long walks and prolong standing during the course of the stasis dermatitis as this can only aggravate the condition more. Incessant scratching is to be avoided to prevent onset of breaks or lesions in the skin that can later result to infection.