American Journal of Clinical Dermatology

, Volume 18, Issue 3, pp 383–390

Stasis Dermatitis: Pathophysiology, Evaluation, and Management

  • Swaminathan Sundaresan
  • Michael R. Migden
  • Sirunya Silapunt
Review Article

DOI: 10.1007/s40257-016-0250-0

Cite this article as:
Sundaresan, S., Migden, M.R. & Silapunt, S. Am J Clin Dermatol (2017) 18: 383. doi:10.1007/s40257-016-0250-0


Stasis dermatitis commonly occurs in older age. It is caused by venous hypertension resulting from retrograde flow due to incompetent venous valves, valve destruction, or obstruction of the venous system. Further tissue changes arise from an inflammatory process mediated by metalloproteinases, which are up-regulated by ferric ion from extravasated red blood cells. Stasis dermatitis presents initially as poorly demarcated erythematous plaques of the lower legs bilaterally, classically involving the medial malleolus. It is one of the spectrum of cutaneous findings that may result from chronic venous insufficiency. Its mimics include cellulitis, contact dermatitis, and pigmented purpuric dermatoses. Duplex ultrasound is useful in demonstrating venous reflux when the clinical diagnosis of stasis dermatitis is inadequate. Conservative treatment involves the use of compression therapy directed at improving ambulatory venous pressure. Interventional therapy currently includes minimally invasive techniques such as endovenous thermal ablation and ultrasound-guided foam sclerotherapy, which have supplanted the use of open surgical techniques.

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.University of Texas McGovern Medical School at HoustonHoustonUSA
  2. 2.Departments of Dermatology and Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.Department of DermatologyUniversity of Texas McGovern Medical School at HoustonHoustonUSA

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