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Refractory Stasis Dermatitis Due to Chronic Venous Insufficiency With Psychosocial Worsening in 2 Septuagenarian Patients Treated With Hyaluronic Acid-Succinic Acid Intradermotherapy

Zhao Q, Zambrano MP, Brito S, Bin BH, Ran Y, Leguina-Ruzzi A

The American journal of case reports, 2026

Abstract

BACKGROUND Stasis dermatitis is a chronic inflammatory dermatosis secondary to chronic venous insufficiency. Treatment of refractory cases remains challenging. High-molecular-weight non-crosslinked hyaluronic acid (HMWNCHA) combined with succinic acid (SA) possesses anti-inflammatory and regenerative properties. We report 2 septuagenarian patients with refractory stasis dermatitis and psychosocial deterioration treated with intradermal HMWNCHA plus SA. CASE REPORT Case 1 involved a 77-year-old man with chronic venous insufficiency and refractory stasis dermatitis associated with severe symptoms, impaired mobility, and psychosocial deterioration. After failure of conventional therapies, he received 2 sessions of intradermal HMWNCHA plus SA administered 1 month apart, resulting in marked and sustained clinical and psychosocial improvement at 6-month follow-up. Case 2 involved a 75-year-old woman with refractory unilateral stasis dermatitis secondary to chronic venous insufficiency. Following the same treatment protocol, substantial improvement was observed after the first session, with near-complete lesion resolution after the second session and sustained remission at 6-month follow-up. No treatment-related adverse effects were reported. CONCLUSIONS In these 2 patients with refractory stasis dermatitis, intradermal HMWNCHA plus SA was associated with marked and sustained clinical improvements and enhanced quality of life. Further studies are warranted to confirm these findings.

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