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Review
. 2023 Mar;24(2):275-286.
doi: 10.1007/s40257-022-00753-5. Epub 2023 Feb 17.

Stasis Dermatitis: An Overview of Its Clinical Presentation, Pathogenesis, and Management

Gil Yosipovitch  1 , Susan T Nedorost  2 , Jonathan I Silverberg  3 , Adam J Friedman  4 , Juliana M Canosa  5 , Amy Cha  6
Affiliations
Review

Stasis Dermatitis: An Overview of Its Clinical Presentation, Pathogenesis, and Management

Gil Yosipovitch et al. Am J Clin Dermatol. 2023 Mar.

Abstract

Stasis dermatitis is a chronic inflammatory skin disease of the lower extremities. It typically occurs in older individuals and is the cutaneous manifestation of venous hypertension caused by venous reflux. Such retrograde venous blood flow is the result of incompetent venous valves, valve destruction, or venous obstruction. Stasis dermatitis is eczematous. The associated impairment of venous valves may cause swelling of the legs, leading to serious conditions including venous ulcerations. Diagnosis can be challenging because of its clinical resemblance to other skin conditions and poor clinical recognition by physicians. The cornerstones of stasis dermatitis treatment are compression therapy to ameliorate pain and swelling, topical treatments to alleviate secondary skin changes, and interventional treatment options to correct the underlying causes of venous reflux. Given the central role of inflammation of the lower extremities in driving the cutaneous changes characteristic of stasis dermatitis, new therapeutic approaches that target the inflammation are under clinical evaluation in patients with stasis dermatitis.

Plain language summary

Stasis dermatitis is a skin disease that can affect a person for a long time. It affects the legs of older people who have a disease called chronic venous insufficiency. This is when a person’s veins have difficulty sending blood from their limbs back to their heart. Stasis dermatitis is caused by increased pressure inside a person’s veins. Its signs and symptoms are skin discoloration, itch, dryness, and scaling and can be similar to the signs and symptoms of cellulitis and allergic contact dermatitis. Cellulitis is a common skin infection caused by bacteria. Cellulitis causes redness, swelling, and pain. Allergic contact dermatitis is an itchy skin rash caused by contact with something that irritates the skin. Stasis dermatitis is usually diagnosed after a healthcare provider has looked at person’s skin and their medical history. Treatment for stasis dermatitis should treat the chronic venous insufficiency that causes the disease. It should also treat the skin lesions caused by stasis dermatitis. One way to treat stasis dermatitis is to reduce pain and swelling. This is done by applying pressure with compression stockings or bandages. Minor surgery can treat the venous insufficiency that causes stasis dermatitis. No treatments have been approved for the skin symptoms associated with stasis dermatitis. New ways to treat such symptoms need to be developed.

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Conflict of interest statement

GY has been a consultant and an advisor for Pfizer Inc., Bellus, Eli Lilly and Company, Galderma, Kiniksa, LEO Pharma Novartis, Sanofi-Regeneron, and Trevi Therapeutics and is a principal investigator for Pfizer Inc., Kiniksa, LEO Pharma, Galderma, and Sanofi-Regeneron. JS served as an investigator for Celgene, Eli Lilly and Company, F. Hoffmann-LaRoche, Menlo Therapeutics, Realm Therapeutics, Regeneron, and Sanofi; as a consultant for Pfizer Inc., AbbVie, Anacor, AnaptysBio, Arena Pharmaceuticals, Dermavant, Dermira, Eli Lilly and Company, Galderma, GlaxoSmithKline, Glenmark, Incyte, Kiniksa Pharmaceuticals, LEO Pharma, Menlo Therapeutics, Novartis, Realm Therapeutics, Regeneron, and Sanofi; and as a speaker for Regeneron and Sanofi. JMC and AC are employees and stockholders of Pfizer Inc. AF has been a consultant and advisor for Pfizer Inc., AbbVie, Aveeno, Dermavant, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly and Company, Graegis, Galderma, Janssen, L'Oréal, Microcures, Mino Labs, Novartis, Sanofi-Regeneron, and Zylo Therapeutics and is a speaker for AbbVie, Bristol Myers Squibb, Dermavant, Janssen, and Sanofi-Regeneron. SN has received a Pfizer Learning and Change grant and has been an advisor for Pfizer Inc. and is Dermatology editor for the New England Journal of Medicine Healer educational resource.

Figures

Fig. 1
Fig. 1
Stasis dermatitis with hyperpigmentation. Figure used with permission from https://www.sciencephoto.com
Fig. 2
Fig. 2
Stasis dermatitis with leg ulcers. Figure used with permission from https://www.sciencephoto.com
Fig. 3
Fig. 3
Protein expression of MMPs and their TIMPs in extracts of skin samples from patients with stasis dermatitis. Data were taken from Western blots with monoclonal antibodies against MMP-1, MMP-2, MMP-13, TIMP-1, and TIMP-2 in stasis dermatitis and control skin lesions. Densitometric evaluations of immunoreactive blots for MMP-1, MMP-2, MMP-13, TIMP-1, TIMP-2 from stasis dermatitis (black bars) and healthy skin (white bars) are shown. Data are mean ±SEM; n = 10 for stasis dermatitis and n = 4 for control. The significance of difference was determined by an unpaired Student t test and is indicated in each mapped group. Figure used with permission from Herouy et al. [46] J Dermatol Sciences, 2001. MMP matrix metalloproteinase, ns not significant, SEM standard error of the mean, TIMP tissue inhibitor of metalloproteinase. *p < 0.05
Fig. 4
Fig. 4
Immunohistochemical detection of MMP-1, MMP-2, and MMP-13 in lesions of stasis dermatitis. Increased immunoreactive staining was observed in skin from stasis dermatitis lesions for a MMP-1, b MMP-2, and c MMP-13. Representative photographs from one patient are shown. The experiment was repeated with comparable results (n = 2 for stasis dermatitis; n = 2 for control). Figure used with permission from Herouy et al. [46] J Dermatol Sciences, 2001. MMP matrix metalloproteinase
See this image and copyright information in PMC

References

    1. Rzepecki AK, Blasiak R. Stasis dermatitis: differentiation from other common causes of lower leg inflammation and management strategies. Curr Geriat Rep. 2018;7(4):222–227. doi: 10.1007/s13670-018-0257-x. - DOI
    1. Sundaresan S, Migden MR, Silapunt S. Stasis dermatitis: pathophysiology, evaluation, and management. Am J Clin Dermatol. 2017;18(3):383–390. doi: 10.1007/s40257-016-0250-0. - DOI - PubMed
    1. Theodosat A. Skin diseases of the lower extremities in the elderly. Dermatol Clin. 2004;22(1):13–21. doi: 10.1016/S0733-8635(03)00113-X. - DOI - PubMed
    1. Bergan JJ, Schmid-Schönbein GW, Smith PDC, Nicolaides AN, Boisseau MR, Eklof B. Chronic venous disease. N Engl J Med. 2006;355(5):488–498. doi: 10.1056/NEJMra055289. - DOI - PubMed
    1. Labropoulos N. Hemodynamic changes according to the CEAP classification. Phlebolymphol. 2003;40(4):130–136.