Stasis Eczema Flashcards
What are other names for stasis eczema?
varicose eczema, gravitational eczema, hypostatic eczema
What is stasis eczema?
Disorder of the lower limbs that arises from venous hypertension (venous insufficiency of legs- blood not going back to the heart)
What else may occur in addition to eczema in this condition?
Oedema, induration, ulceration, fibrosis of the skin
Traditional names of Stasis Eczema
Pouring down sore
Damp Toxin Sore
Old Festering Leg
Shank Sore
What are the 7 lesions associated with Stasis Eczema?
- Oodema
- Eczema
- Pigmentation
- Venous Flare
- Varicosities
- Atrophie Blanche
- Ulceration
What is an early feature of stasis eczema which tends to start on inner aspect of ankle before spreading to the tibia and dorsum of the foot?
Oedema
How does the eczema often start?
As an asymmetrical red patch on the inner ankle
After a length of time how will it spread?
Further around to affect outer aspects of ankle and possibly even whole lower leg. Eventually the affected area becomes scaly. May stay asymmetrical but sometimes can affect the other leg
What can happen in severe cases or following the use of topical medications?
Can spread to other parts of the body
Dilated veins around the ankle and dorsum of the foot- predate any eczema
Venous flare
Small white plaques of sclerosis indicating severe blood stasis (more severe than purple lesions)
Atrophie Blanche
What two TCM patterns are associated with stasis eczema?
- Damp heat pouring downwards
- Injury to the vessels by Lao
In biomedicine, what conditions can contribute to stasis eczema?
- Venous thrombosis
- Absent valves- usually inherited
- Disease-compromised muscle pump- results from neuromuscular disease
What can complicate the diagnosis of stasis eczema?
allergic contact dermatitis
What other conditions need to be considered in differential diagnosis?
Nummular eczema and psoriasis
What symptoms can be seen in the pattern of damp heat pouring down with stasis?
Pitting oedema of ankles, pigmented changes of the skin of the affected leg, background macular erythema. Possible weeping eczema with yellow or clear exudation, vesiculation
What formula is used to treat damp heat pouring down with stasis?
Bi Xie- 30 g
Huang Bai- 9 g
Chuan Niu Xi- 15 g
Yi Yi Ren- 30 g
Cang Zhu- 12 g
Ze Lan- 9 g
Hong Hua- 9 g
Tao Ren- 9 g
Bai Xian Pi- 12 g
Mu Gua- 15 g
Gan Cao- 6 g
What TCM pattern is usually present in the chronic phase?
Stasis of blood with qi xu
What symptoms do you see in stasis of blood with qi xu?
venous flare, varicosities, atrophie blanche. dry, lichenified, pigmented skin. Leg ulcers can be common. Systemic signs of qi xu
What formula is used to treat stasis of blood with qi xu?
Dang Gui Wei- 12 g
Huang Qi- 30 g
Chi Shao- 12 g
Chuan Xiong- 9 g
Tao Ren- 9 g
Qian Cao Gen- 15 g
Chuan Niu Xi- 15 g
Bai Xian Pi- 12 g
Mu Gua- 15 g
Gan Cao- 6 g
