STASIS DERMATITIS

• Stasis dermatitis occurs as a result of venous stasis on the lower portions of the legs. It is more common in people who are 50 or older and is also called as venous eczema. People with stasis dermatitis usually experience swollen legs and feet, open sores, or itchy and reddish skin

• Underlying cause is usually chronic venous insufficiency, age related venous valvular incompetency
• Less commonly: DVT, surgical stripping of veins, congenital valve absence

• The Dermatitis may be acute, sub acute or chronic
• It differs from other forms of dermatitis, firstly by showing brownish black pigmentation and secondly, by resulting in some instances in ulceration and atrophic scarring
• The surrounding skin shows changes due to venous stasis- hyper pigmentation, indurations of skin and lipodermatosclerosis in late stage
• Discoid eczema is more common on lower legs usually on the anterior or anterolateral aspect

Differential diagnosis

• Allergic contact dermatitis usually caused by topical medications
• Infected ulcer with infective eczematoid dermatitis
• Dermatophyte infection may present as diffuse erythema and scaling
• Psoriasis may present as single irritable plaque on the leg but is usually more scaly and clearly marginated

• Usually based on patient history and clinical appearance

• Underlying venous hypertension should be controlled
• Well fitted stockings
• Legs should be elevated when patient is recumbent

Internal medicines

• Sonitamritha kashaya
• Manjishtadi kashaya
• Kaisora guggulu
• Triphala guggulu
• Madhusnuhi rasayana
• Guggulu panchapala choorna with madhu

Procedures

• Virechana - Avipathi choorna
• Sira vyadha
• Triphala kshalana
• Shuda doorvadi kera- ext application