Ulcerating stasis dermatitis of the forearm associated with arteriovenous graft and central vein stenosis.

INTRODUCTION

Stasis dermatitis is a pathologic condition of the skin that most commonly occurs in the lower limb, where it is caused by chronic venous insufficiency. Stasis dermatitis of the upper limb is rare.

CASE REPORT

A 45-year-old male, resident in Angola, presented to the emergency department with an ulcer encompassing the entire left forearm. Past medical history comprised arterial hypertension and end stage renal disease treated with hemodialysis. Dialysis access consisted of a left brachial-basilic AV graft obtained 4 years before. The patient also reported that a right internal jugular vein catheter was used previously during the maturation of the left brachial-basilic AV graft. Stenosis of the left brachiocephalic vein was documented at angiography. Angioplasty was performed, with complete resolution of the wound 2 months after admission.

CONCLUSION

The differential diagnosis of extensive ulcer of the forearm must include neoplasms, cellulitis, and/or deep tissue infection with secondary ulceration, but it is also important to maintain suspicion for venous stasis syndrome as a rare but possible cause of these lesions.