TAILIEUCHUNG - Chapter 053. Eczema and Dermatitis (Part 5)

Stasis dermatitis. An example of stasis dermatitis showing erythematous, scaly, and oozing patches over the lower leg. Several stasis ulcers are also seen in this patient. Stasis Dermatitis and Stasis Ulceration: Treatment Patients with stasis dermatitis and stasis ulceration benefit greatly from leg elevation and the routine use of compression stockings with a gradient of at least 30–40 mmHg. Stockings providing less compression, such as antiembolism hose, are poor substitutes. Use of emollients and/or midpotency topical glucocorticoids and avoidance of irritants are also helpful in treating stasis dermatitis. Protecting the legs from injury, including scratching, and control of chronic edema. | Chapter 053. Eczema and Dermatitis Part 5 Stasis dermatitis. An example of stasis dermatitis showing erythematous scaly and oozing patches over the lower leg. Several stasis ulcers are also seen in this patient. Stasis Dermatitis and Stasis Ulceration Treatment Patients with stasis dermatitis and stasis ulceration benefit greatly from leg elevation and the routine use of compression stockings with a gradient of at least 30-40 mmHg. Stockings providing less compression such as antiembolism hose are poor substitutes. Use of emollients and or midpotency topical glucocorticoids and avoidance of irritants are also helpful in treating stasis dermatitis. Protecting the legs from injury including scratching and control of chronic edema are essential to prevent ulcers. Diuretics may be required to adequately control chronic edema. Stasis ulcers are difficult to treat and resolution is slow. It is extremely important to elevate the affected limb as much as possible. The ulcer should be kept clear of necrotic material by gentle debridement and covered with a semipermeable dressing and a compression dressing or compression stocking. Glucocorticoids should not be applied to ulcers since they may retard healing however they may be applied to the surrounding skin to control itching scratching and additional trauma. Secondarily infected lesions should be treated with appropriate oral antibiotics but it should be noted that all ulcers will become colonized with bacteria and the purpose of antibiotic therapy should not be to clear all bacterial growth. Care must be taken to exclude treatable causes of leg ulcers hypercoagulation vasculitis before beginning the chronic management outlined above. Seborrheic Dermatitis Seborrheic dermatitis is a common chronic disorder characterized by greasy scales overlying erythematous patches or plaques. Induration and scale are generally less prominent than in psoriasis but clinical overlap exists between these diseases sebopsoriasis. The most .