Management of stasis dermatitis

MRSA: methicillin-resistant Staphylococcus aureus.

* Topical corticosteroids (eg, triamcinolone or fluocinolone) are applied once or twice daily for 1 to 2 weeks; an ointment base without emulsifiers or additives is preferred to minimize risk of contact sensitization.

¶ Superficial infection (impetiginization) is usually treated with topical mupirocin ointment 3 times per day for 5 days. May use antibacterial washes to decrease bacterial load. Patients with suspected cellulitis require systemic antibiotic therapy. Pending culture results, empiric therapy covering group B Streptococcus, MRSA, and other beta-hemolytic streptococci is initiated. Refer to UpToDate topics on the treatment of acute cellulitis and erysipelas in adults for further guidance.

Δ In the setting of acute stasis dermatitis, allergic contact dermatitis is best treated with a short course of systemic corticosteroids (eg, prednisone 20 to 40 mg daily for 5 to 7 days or a single dose of intramuscular triamcinolone 40 mg).