Sunday, April 10, 2016

Chronic Stasis Dermatitis

Abstract: 68 yo man with chronic dermatitis of left leg

History: The patient has had a chronic dermatitis of left leg for over ten years.  He has been seen at the Wound Care Clinic for over three years.  What worked best in the past was an Unna boot but these are not used as commonly anymore as we have newer, more high-tech types of bandages. 

O/E: He has chronic lymphedema of the left leg, which periodically develops elephantiasis-like changes. The examination woody edema left leg, that is erythematous with crusted areas.  It looks clean today and there is no evidence of secondary infection.
Impression:  Chronic dermatitis of his left leg.  It is most likely a chronic stasis eczema. 

Comments: He has been diligent about home care.  For the time being, he will use wet dressings with a dilute bleach (a half cup of Chlorox per 40 gallons of water in a bathtub) and zinc oxide-like paste.  He will be seen back in two weeks.  Consider going back to an Unna boot.

What are your thoughts?


  1. from Noah Scheinfeld: i have a patient with crazy bad ulcers should I send your pictures of him. besides that i use the treatments I put in this chapter i wrote on Livedoid Vasculopathy you pump up the anticoagulants and do pt ot and compression

  2. Back to basics. This is most likely a long standing chronic stasis eczema. Will send swab for bacterial culture. Most worrying aspect is undiagnosed contact dermatitis to medicaments. Once patch test has excluded contact dermatitis, I will use plain wet compress with dil. KMNO4 with emulsifying ointment/soft paraffin wax. Low strength topical steroid ointments will be useful. I would avoid zinc oxide paste. My favourite is a 4-layer supportive stocking for at least 3 days interval. this will hasten recovery and healing. He will probably need such stocking for weeks to months!!


We welcome your comments. We endeavor to serve your patients and you. If you want us to respond, please add your name and email address. Some people have trouble uploading comments. In that case, please send comments directly to Thank you.