The most common initial location includes the medial malleolus, but it may involve the entire distal lower extremity (gaiter zone) over time. Obesity, congestive heart failure, deep vein thrombosis (DVT), history of a leg fracture, prior surgery in the lower extremities or pelvic area, venous hypertension secondary to prolonged standing, and congenital absence of venous valves are known risk factors. Stasis dermatitis is most prevalent in older individuals.
Stasis dermatitis is often associated with pruritus and may cause an aching or throbbing discomfort. The condition can be complicated by ulceration and infection. Individuals with stasis dermatitis are at an increased risk of allergic contact dermatitis.
I83.10 – Varicose veins of unspecified lower extremity with inflammation
35498005 – Stasis dermatitis
Differential Diagnosis & Pitfalls
- Cellulitis – Generally asymmetric and accompanied by leukocytosis, tachycardia, fever, and tenderness to palpation.
- Allergic contact dermatitis – Concomitant allergic contact dermatitis in patients with stasis dermatitis is common, often because these patients self-treat with many topical agents prior to seeking medical attention.
- Erythema nodosum (usually without scale)
- Eczema craquelé
- Atopic dermatitis
- Tinea corporis or pedis – A potassium hydroxide (KOH) preparation should be performed to rule out this entity.
- Majocchi granuloma
- Necrobiosis lipoidica
- Pretibial myxedema
- Nummular dermatitis
- Lichen simplex chronicus
- Benign pigmented purpuras – The eczematous type (Doucas and Kapetanakis).
- Leukocytoclastic vasculitis