Stasis Dermatitis Treatment & ManagementApr 17, Author: Midpotency corticosteroids, such as triamcinolone 0. Infection is a particular concern in stasis dermatitis, since topical corticosteroids make the patient more susceptible to infection. Open excoriations and erosions should be treated with a topical antibiotic. Triamcinolone topical is a moderate-potency steroid with anti-inflammatory properties.
Stasis Dermatitis in Adults: Condition, Treatments, and Pictures - Overview | skinsight
Apr 17, Author: Midpotency corticosteroids, such as triamcinolone 0. Infection is a particular concern in stasis dermatitis, since topical corticosteroids make the patient more susceptible to infection.
Open excoriations and erosions should be treated with a topical antibiotic. Triamcinolone topical is a moderate-potency steroid with anti-inflammatory properties.
It treats inflammatory dermatosis that is responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.
These are used to treat open excoriations and erosions. Obvious superficial impetiginization should be treated with topical mupirocin or a systemic antibiotic with activity against Staphylococcus and Streptococcus species eg, dicloxacillin, cephalexin, cefadroxil, levofloxacin.
Bacitracin prevents the transfer of mucopeptides into the growing cell wall, which causes inhibition of bacterial cell wall synthesis. Bacitracin prevents transfer of mucopeptides into the growing cell wall, which causes inhibition of bacterial cell wall synthesis.
Polymyxin B damages the bacterial cytoplasmic membrane and alters permeability, causing intracellular constituents to leak. This agent is used to treat open excoriations and erosions. Dicloxacillin is used in the treatment of infections caused by penicillinase-producing staphylococci. It may be used as initial therapy when staphylococcal infection is suspected. Cephalexin is a first-generation cephalosporin that arrests bacterial growth by inhibiting bacterial cell wall synthesis.
It has bactericidal activity against rapidly growing organisms. It has primary activity against skin flora and is used for skin infections or prophylaxis in minor procedures. It is used as an alternative agent for MRSA infection.
Cefadroxil is a first-generation semisynthetic cephalosporin that arrests bacterial growth by inhibiting bacterial cell wall synthesis. It has bactericidal activity against rapidly growing organisms, including S aureus , S pneumoniae , S pyogenes , Moraxella catarrhalis , E coli , Klebsiella species , and Proteus mirabilis.
Pimecrolimus is indicated for eczema and atopic dermatitis. It was the first nonsteroid cream approved in the United States for mild-to-moderate atopic dermatitis. Pimecrolimus is derived from ascomycin, a natural substance produced by fungus Streptomyces hygroscopicus var ascomyceticus. This agent selectively inhibits production and release of inflammatory cytokines from activated T cells by binding to cytosolic immunophilin receptor macrophilin The resulting complex inhibits phosphatase calcineurin, thus blocking T-cell activation and cytokine release.
Cutaneous atrophy was not observed in clinical trials, a potential advantage over topical corticosteroids. Tacrolimus reduces itching and inflammation by suppressing release of cytokines from T cells.
Additionally, tacrolimus may inhibit release of preformed mediators from skin mast cells and basophils and may down-regulate expression of the high-affinity IgE receptor FCeRI on Langerhans cells. Tacrolimus can be used in patients as young as 2 years. It is more expensive than topical corticosteroids. This agent is available as ointment in concentrations of 0. Diagnostic accuracy in patients admitted to hospitals with cellulitis. A retrospective study of patch test results from patients with stasis dermatitis or leg ulcers.
Retesting of 50 patients. Gooptu C, Powell SM. The problems of rubber hypersensitivity Types I and IV in chronic leg ulcer and stasis eczema patients. Frequency of sensitization to antimicrobials in patients with atopic eczema compared with nonatopic individuals: Comparative frequency of patch test reactions to topical antibiotics.
Higher soluble P-selectin is associated with chronic venous insufficiency: The San Diego Population Study. Skin damage in chronic venous insufficiency: J R Soc Med. Skin oxygen tension in venous insufficiency of the lower leg. Dermal pericapillary fibrin in venous disease and venous ulceration.
Dermal tissue fibrosis in patients with chronic venous insufficiency is associated with increased transforming growth factor-beta1 gene expression and protein production. White cells, skin blood flow and venous ulcers. Causes of venous ulceration: Beauregard S, Gilchrest BA. A survey of skin problems and skin care regimens in the elderly. Prevalence of skin diseases in old age.
The epidemiology of chronic venous insufficiency and varicose veins. Chronic venous insufficiency in Italy: Eur J Vasc Endovasc Surg. Stasis ulcer and dermatitis caused by artificial arteriovenous fistula created 33 years previously for the treatment of poliomyelitis. Stasis dermatitis as a complication of amlodipine therapy. Weaver J, Billings SD. Initial presentation of stasis dermatitis mimicking solitary lesions: J Am Acad Dermatol.
Distinguishing cellulitis from its mimics. Cleve Clin J Med. The clinical spectrum of lipodermatosclerosis. Pathophysiology, Evaluation, and Management. Am J Clin Dermatol. Treatment of refractory venous stasis ulcers with autologous platelet-rich plasma and light-emitting diodes: Pigmentation due to stasis dermatitis treated successfully with a noncoherent intense pulsed light source.
Treatment of resistant venous stasis ulcers and dermatitis with the end-diastolic pneumatic compression boot. Treatment of intractable skin ulcers caused by vascular insufficiency with allogeneic cultured dermal substitute: Use of compression stockings in chronic venous disease: Drug treatment of chronic venous insufficiency and venous ulceration: Successful treatment of stasis dermatitis with topical tacrolimus.
Hypersensitivity to topical corticosteroids. Oral doxycycline with topical tacrolimus for treatment of stasis dermatitis due to chronic venous insufficiency: Microcirculation and venous ulcers: Sensitizing potential of triclosan and triclosan-based skin care products in patients with chronic eczema. American Academy of Dermatology Disclosure: Jeffrey Meffert, MD is a member of the following medical societies: Jean-Hilaire Saurat, MD is a member of the following medical societies: Richard P Vinson, MD is a member of the following medical societies: Sign Up It's Free!
If you log out, you will be required to enter your username and password the next time you visit. Share Email Print Feedback Close. Medication Summary The goals of pharmacotherapy are to reduce morbidity and prevent complications. Corticosteroids Class Summary These agents elicit anti-inflammatory and immunosuppressive properties.
Antibiotics, Other Class Summary These are used to treat open excoriations and erosions. Topical Immunomodulators Class Summary These agents modify immune processes that promote inflammation. This patient exhibits the classic hyperpigmentation and varicosities of stasis dermatitis.
There is inflammatory eczematous change overlying the medial ankle, with healed scarring from recent ulceration. This patient with chronic stasis dermatitis exhibits classic features, such as erythema, hyperpigmentation, and dilated superficial veins reflecting poor function of the deep venous system.
The condition is typically confined to the lower leg, particularly the medial portion of the leg. Patient with stasis dermatitis. The large scar on the calf resulted from military shrapnel. Injuries to the venous system due to trauma or surgery are common factors in the development of stasis dermatitis.