Dr. M.J. Bazos, MD Patient Handout

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 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.