Dr. M.J. Bazos, MD
Patient
Handout
DERMATITIS,
STASIS
About Your
Diagnosis
Stasis dermatitis is a
chronic inflammation and irritation of the skin, usually in the lower legs,
resulting from poor circulation of blood and lymphatic fluids. It is caused by
conditions that slow normal fluid return from the feet to the heart. Common
causes include lack of movement, obesity, and congestive heart failure. It is
very common, affecting 50% of Americans with these risk
factors.
Living With Your
Diagnosis
Signs and symptoms of stasis
dermatitis include reddened, swollen feet and lower legs. Often the skin appears
shiny. The feet may become painful as swelling worsens. Small sores or ulcers
may appear on the feet or lower legs, and may not heal well. The effects of the
swelling and skin breakdown include predisposition to infection, which may be
limited to an ulcer or become so extensive that deeper tissues (muscle or bone)
may be involved. Severe pain and swelling also limit a patient’s activity,
as walking becomes more painful. This decrease in exercise worsens the condition
further and results in progressive disease if not
corrected.
Treatment
Treatment
consists of reducing the fluid trapped in the feet and lower legs. Mechanical
devices such as hospital-grade support hose or leg compression pumps are very
effective in improving fluid return from the legs if used consistently. Some
patients may also benefit from diuretics (water pills). Because diuretics may
cause potassium or calcium losses, or result in fluid imbalance, it is essential
that they only be used if prescribed by your physician. Not all patients can use
diuretic therapy.
The
DOs
• Do take diuretics exactly
as prescribed. Your doctor will need to check your potassium, calcium, and
kidney function periodically while on these medicines. Check with your doctor
for the schedule of testing right for
you.
• Do use your mechanical devices
such as support hose or compression pumps every day. Compression hose should be
ordered specifically for you. Your nurse will check your thigh and leg length
measurements to ensure the proper size is ordered. Hose should be bought in sets
of two pairs, so one can be worn while the other is laundered. Put the hose on
first thing in the morning after bandaging any ulcers or sores carefully. They
should be removed at night for
sleeping.
• Do learn to use your
compression pump properly. Your home health nurse will instruct you in the care
of the inflatable cuffs as well as safe use of the pump. Pumps should be used as
directed by your doctor for several sessions each day. Be sure to follow
instructions carefully to ensure proper fit of the cuffs and adequate time for
them to work.
• Do eat a low-fat,
low-cholesterol diet and avoid excess salt. Ask your doctor how much salt you
may have each day. In general, more than 4 grams (4,000 mg) of sodium will
increase foot swelling, and some patients must limit their intake to even lower
levels. Local bookstores have many books about diet to help you calculate your
daily fat, cholesterol, and salt intake. These are helpful to plan meals, and
the best ones will list the values for typical fast-food choices as well. Also
ask your doctor whether you need to limit water intake. Although most
individuals need 8 glasses of water per day, patients with stasis dermatitis may
need slightly less. Check with your doctor to be
sure.
• Do exercise daily. Twenty
minutes of mild-tomoderate exercise (walking), if approved by your doctor, will
improve circulation and fluid return from the legs. If walking is too difficult
because of swelling, physical therapy may be used to improve strength and range
of motion. When seated or reclining, elevation of the legs may be helpful as
well.
The
DON’Ts
• Don’t take
diuretics prescribed for other
individuals.
• Don’t use more
that 4 grams of salt per day.
•
Don’t miss blood tests for potassium and kidney
function.
• Don’t exercise
without your doctor’s
permission.
• Don’t sit for
prolonged periods with your legs crossed or your feet hanging
down.
When to Call Your
Doctor
• If you notice new sores,
ulcers, or redness in the feet or
legs.
• If you have increased swelling in
the legs despite use of hose or
pumps.
• If you have fever, chills,
or shortness of breath.