Stasis Dermatitis: Pathophysiology, Evaluation, and Management.

Area of Science:

• Dermatology
• Vascular Medicine

Background:

• Stasis dermatitis is a common condition in older individuals, linked to chronic venous insufficiency.
• It results from venous hypertension caused by incompetent valves, valve destruction, or venous obstruction.
• Inflammatory processes involving metalloproteinases, upregulated by iron from red blood cells, contribute to tissue changes.

Purpose of the Study:

• To summarize the pathophysiology, clinical presentation, differential diagnoses, and treatment of stasis dermatitis.
• To highlight the role of venous hypertension and inflammation in stasis dermatitis development.
• To review diagnostic tools and evolving therapeutic strategies for stasis dermatitis.

Main Methods:

• Literature review of stasis dermatitis, focusing on etiology, clinical findings, and management.
• Analysis of diagnostic modalities, including duplex ultrasound for venous reflux assessment.
• Evaluation of treatment options, from conservative compression therapy to interventional techniques.

Main Results:

• Stasis dermatitis presents as bilateral erythematous plaques on the lower legs, often near the medial malleolus.
• Differential diagnoses include cellulitis, contact dermatitis, and pigmented purpuric dermatoses.
• Duplex ultrasound aids in diagnosing venous reflux when clinical presentation is ambiguous.

Conclusions:

• Conservative management with compression therapy is the mainstay for improving venous pressure.
• Minimally invasive interventional therapies, such as endovenous thermal ablation and foam sclerotherapy, are increasingly preferred over open surgery.
• Effective management requires addressing the underlying venous hypertension and inflammation.