Venous stasis


  • Decreased rate of return of venous blood flow to heart (most commonly in lower extremities)
  • Leads to characteristic vascular and skin changes
  • Common in individuals with chronic vascular disease, diabetes, obesity, smoking history, prolonged immobility

Clinical Features

Long term venous stasis skin changes
Chronic venous stasis ulcer.

Venous stasis dermatitis

  • Skin becomes darker/purple, dry, tight, and hairless
    • In severe cases may see venous insufficiency ulcers
  • Patients may complain of leg heaviness, fatigue, or cramping
  • Unlike cellulitis, erythema from venous stasis tends to change with dependent positioning of the affected limb

Differential Diagnosis

Unilateral leg swelling

Differential Diagnosis of Pedal Edema


  • Duplex scan if suspicion for DVT


  • Limb elevation, compression, and increased exercise


  • Discharge
  • Considerations for admission to medicine or surgery for ulcers:[1]
    • Patients with significant occlusive arterial disease require specialist assessment of the severity
    • For treatment of underlying medical problems such as rheumatoid arthritis, peripheral vascular disease, diabetes mellitus, etc.
    • Ulcers with mixed etiologies, diabetic ulcers
    • Suspected malignant ulcers
    • Nonhealing ulcers (a minimum of at least 6 months of compression and local wound care followed by reassessment of venous function should be done before operative plastic surgical intervention is considered)
    • Rapid deterioration of the ulcer
    • Recurrent ulcers
    • Reduced ABPI <0.8 or increased ABPI >1.0
    • Infected foot
    • Ischemic foot

See Also

External Links


  1. Dogra S, Sarangal R. Summary of recommendations for leg ulcers. Indian Dermatol Online J. 2014;5(3):400-407. doi:10.4103/2229-5178.137829