Stasis pigmentation and chronic alcoholism

Drug and Alcohol Dependence, 25 (1990) 49 Elsevier Scientific Publishers Ireland Ltd.

Stasis

49

pigmentation

C.E . Gonzblez-Reimers,

F. Santolaria-Fernbdez, P. Machado-Machado

Hospital Universitario

de Canarias, La Laguna, (Received

Clinical alcoholics.

observation

Key words: alcoholism;

of stasis

stasis

and chronic alcoholism

pigmentation

September

of the lower

Tenerife,

21st,

N. Batista-L6pez

and

Canary Islands Epain)

1989)

limbs of alcoholics

with a prevalence

of 52.5%

vs. 17.9%

in non-

pigmentation

patients with stasis pigmentation had consumed alcoholic beverages for longer time than alcoholics without pigmentation Cp < 0.021, but between these two groups of patients no differences were observed with respect to the daily ethanol consumption, MCV and GGT. Stasis pigmentation was not associated with sex. In our series, the relative risk to be alcoholic when stasis pigmentation is present reaches 2.93, but if we only consider patients under 65 years old, the relative risk reaches 7.17 (prevalence of stasis pigmentation among alcoholics = 56.25%, vs. 7.84% among non-alcoholics). Thus, from our data we conclude that stasis pigmentation is strongly associated with alcoholism, and is related to the duration of the alcoholic intoxication. Possibly this condition is associated with repetitive traumatization of the legs, or with other well-known manifestations of alcoholism, such as telangiectasia, facial erythema and peripheral vasodilatation, a matter which needs further investigation to be clarified.

Stasis pigmentation is a condition characterized by the deposition of hemosiderin within the macrophages of the subcutaneous layers, which confers on the skin of the lower part of the calves and the medial malleolus a brownish colour. The main pathogenetic mechanism involved is the augmented venous capillary pressure, with escape of red blood cells to the interstitium and phagocytation by the macrophages. Thus, venous insufficiency and chronic heart failure account for the most frequent etiologies of this disorder. As far as we know, this condition has not been described in alcoholics [1,2]. Therefore we have performed this study in order to analyse whether or not there is an association between stasis pigmentation and chronic alcoholism - defined as consumption of more than 80 g ethanol per day during at least 5 years. In 202 consecutively admitted patients in a 3month period, we have recorded the following data: age; sex; presence or not of stasis pigmentation; amount of daily ethanol consumption; number of years of ethanol addiction; MCV and GGT serum levels. A strong association between chronic alcoholism and stasis pigmentation was observed (prevalence among alcoholics = 52.5% vs. 17.9% among non-alcoholics (x2 = 28.3; P < 0.00111,although alcoholic patients were younger (P < 0.011. Alcoholic 0376-8716/90/.$03.50 OElsevier Scientific Printed and Published in Ireland

Publishers

Ireland

References 1 2

Ltd.

H.A. Skinner et al., Br. Med. J., 292 (1986) 1703. Criteria committee, National Council on alcoholism. Criteria for the diagnosis of alcoholism. Ann. Intern. Med., 77 (1972) 249.