What is Stasis Dermatitis and how to treat it

Stasis dermatitis is a common eczematous eruption of the lower extremities occurring in order persons. It is usually preceded by varicosities and poor circulation. With the reduction in venous return from the legs, substances normally carried away by the circulation remain in the tissues, causing irritation. The skin often brawny colored associated edema. Itching may or may not occur. Scratching may produce breaks in the epidermis, which can become secondarily infected.

The most important treatment for stasis dermatitis is prevention by careful attention to the treatment of peripheral vascular conditions and prevention of constriction of the circulation to the extremities. Treating lower extremity edema with elevation, compression stockings and Unna boots where applicable ultimately decreases the dermatitis skin changes. Topical corticosteroid improve the eczematous changes. Domeboro soaks may be useful when weeping lesions are present.

How do you get stasis dermatitis

Almost any drug can cause a drug hypersensitivity reaction. The rash occurs because of gradual accumulation of the drug or because of antibodies that develop in response to a component of the medication. Skin manifestations from drugs may have a nonallergic or allergic basis. Some commonly seen skin reactions are maculopapular lesions, purpura, vesicles, bullae, ulcers, and urticaria. The reactions can appear at any time, but the onset is usually sudden.

More about stasis dermatitis 

Type I anaphylactic (urticaria, angioedema), type II cytotoxic (ceullar injury), type III immune complex (serum sickness), or type IV cell-mediated (allergic contact dermatitis, allergic photosensitivity) hypersensitivity reactions may occur. Some drugs may have combined reactions; for example, penicillin may produce both type I and III reactions. Allergic contact dermatitis is commonly seen with drugs used topically. The rash is often bright red, semiconfluent, macular, and popular, generalized and bilateral. Hypersensitivity occurs early when previous sensitization has taken place.

Photosensitivity may occur with certain drugs and may take one of two forms: phototoxicity or photoallergy. Phototoxicity may occur in any person taking a photosensitive drug and results from the reaction of the drug with radiant energy, particularly UV light. Broad-spectrum sunscreen (e.g. zinc oxide, titanium dioxide or avobenzone) which cover the spectrum of UVA, may reduce potential photosensitivity reactions. Photoallergic  reactions are cell-mediated (type IV) hypersensitivity reactions; therefore they effect only a small group of persons after several sensitizing exposures of drug and sunlight.

Caring for stasis dermatitis sufferer 

Treatment of drug hypersensitivity reactions consists of stopping the drug and treating the symptoms with cool, moist compress, antihistamines and topical or systemic corticosteroids. Avoiding direct sunlight, using broad-spectrum sunscreens, and wearing photoprotective clothing may also help.

Patient/Family Teaching

The primary goal of patient education is prevention by making sure patients know the drug to which they are allergic. The patient or family member should know the specific drug name and type of reaction. A Medic-Alert bracelet may be beneficial. Allergy information should be documented on the patient’s record. Nursing care also focuses on helping the patient comply with treatment.