Which condition occurs in the lower leg when varicose veins slow the return of blood and the accumulation of fluid interferes with nourishment of the skin?

• A. Varicose veins
• B. Caput Medusa
• C. Spider veins
• D. Stasis dermatitis

Answer: (D)

Stasis dermatitis is the skin change that develops in chronic venous insufficiency of the leg. When varicose veins slow venous return, fluid and proteins leak into the tissue, causing edema and inflammation. This reduced blood flow to the skin combined with swelling disrupts nourishment and oxygen to skin cells, leading to an eczematous, pruritic eruption with pigment changes from broken red cells (hemosiderin) and eventual thickening or scaling. The dermatitis is a hallmark of long-standing venous hypertension and can precede or accompany venous ulcers. This is different from caput medusae, which relates to portal hypertension in the abdomen; spider veins, which are tiny surface dilated capillaries; and the varicose veins themselves, which are enlarged veins rather than skin changes.