ASK DOCTOR H: Skin condition affects legs

By Dr. Mitchell Hecht

Q: I saw my doctor recently because of a reddened, intensely itchy area on the left inner ankle. He said that it was “stasis dermatitis,” a skin condition caused by my varicose veins. He recommended a steroid cream and to see a vascular surgeon. Can you explain more about this? – S.H., Cumming

A: Stasis dermatitis is a skin condition classically seen in the legs and feet due to chronic swelling from conditions such as varicose veins or congestive heart failure. The arteries are usually working fine, getting freshly oxygenated blood into your legs, but incompetent valves in the leg veins make it difficult to get the blood out. So they swell, become discolored and inflamed.“Stasis” means stagnation of flow; “dermatitis” is a general term describing skin inflammation. If it gets bad enough, skin breakdown and ulceration can occur. Obesity increases the risk of leg swelling and stasis dermatitis.

Compression stockings and leg elevation are time-tested treatments for swelling and itching, but my experience has been that many folks (especially men) find compression hosiery to be uncomfortable and fail to wear them as directed. It’s important to see a vascular specialist to make sure there’s not an arterial circulation problem or leg clot that might be worsened with leg compression. Diuretics help more when the cause is excess blood volume, rather than bad veins. Burrow’s solution can be applied with gauze to weeping areas. Steroid creams are helpful to quiet the itching but need to be used cautiously to avoid further thinning of the skin and leg ulcers. Lastly, in folks who are obese, losing as little as 10 percent of body weight will help decrease swelling and improve symptoms.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Due to the large volume of mail received, personal replies are not possible.

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