Stasis Dermatitis: The Daily PANCE Blueprint
A 67-year-old obese male with a history of prolonged standing at work presents with an erythematous, scaling, eczematous patch on his lower leg. Physical exam also reveals varicose veins, chronic dependent edema, and hyperpigmentation of the lower extremity. Which of the following is the most appropriate initial treatment?
A. Oral corticosteroids
B. Systemic antibiotics
C. Surgical excision of the lesion
D. Topical antifungal therapy
E. Compression stockings and leg elevation
Answer and topic summary
The answer is E. Compression stockings and leg elevation
Stasis dermatitis is a dermatologic manifestation of venous insufficiency. The localized inflammatory reaction leads to proliferation of small blood vessels, perivascular lymphocytic infiltration, extravasated erythrocytes, and hemosiderin-laden macrophages. On physical exam you will see an erythematous, scaling, eczematous patch on the lower legs. It is often associated with other signs of venous insufficiency, such as varicose veins, chronic dependent edema, hyperpigmentation, and ulcerations. Common risk factors for venous insufficiency include prior DVT, smoking, advanced age, obesity, and prolonged standing. Initial treatment of peripheral venous insufficiency entails compression stockings, leg elevation, and exercise.
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Covered under ⇒ PANCE Blueprint Dermatology ⇒ ⇒
This topic is also covered on the EOC dermatology topic lists
