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 M, et al. • The American journal of case reports • 2026
In 2 septuagenarian patients with refractory stasis dermatitis, intradermal high-molecular-weight non-crosslinked hyaluronic acid plus succinic acid was associated with marked and sustained clinical improvements and enhanced quality of life.
Key Findings
Results
A 77-year-old man with refractory stasis dermatitis secondary to chronic venous insufficiency achieved marked and sustained clinical and psychosocial improvement following intradermal HMWNCHA plus SA treatment.
Patient had severe symptoms, impaired mobility, and psychosocial deterioration prior to treatment
Improvement was achieved after failure of conventional therapies
Treatment consisted of 2 sessions of intradermal HMWNCHA plus SA administered 1 month apart
Marked and sustained improvement was observed at 6-month follow-up
No treatment-related adverse effects were reported
Results
A 75-year-old woman with refractory unilateral stasis dermatitis secondary to chronic venous insufficiency showed substantial improvement after the first treatment session and near-complete lesion resolution after the second session.
Patient followed the same treatment protocol as Case 1: 2 sessions administered 1 month apart
Substantial improvement was observed after the first session
Near-complete lesion resolution was observed after the second session
Sustained remission was maintained at 6-month follow-up
No treatment-related adverse effects were reported
Results
Intradermal HMWNCHA plus SA treatment was associated with psychosocial improvement in addition to clinical skin improvement in patients with refractory stasis dermatitis.
Both patients presented with psychosocial deterioration associated with their chronic condition
Case 1 specifically demonstrated psychosocial improvement alongside clinical improvement
Enhanced quality of life was noted in both patients
The treatment addressed both the dermatological and psychosocial dimensions of the disease
Background
High-molecular-weight non-crosslinked hyaluronic acid combined with succinic acid possesses anti-inflammatory and regenerative properties relevant to treating stasis dermatitis.
HMWNCHA is described as high-molecular-weight non-crosslinked hyaluronic acid
Succinic acid (SA) is the co-treatment component
The combination is characterized as having anti-inflammatory and regenerative properties
Stasis dermatitis is described as a chronic inflammatory dermatosis secondary to chronic venous insufficiency
The treatment was delivered via intradermotherapy (intradermal injection)
Conclusions
The authors concluded that further studies are warranted to confirm the findings of HMWNCHA plus SA treatment for refractory stasis dermatitis.
The report is limited to 2 case reports, representing a small sample size
Both patients were septuagenarians (ages 77 and 75)
The authors explicitly state 'Further studies are warranted to confirm these findings'
No treatment-related adverse effects were reported in either case
What This Means
This research describes two elderly patients (ages 77 and 75) who had a stubborn skin condition called stasis dermatitis — a chronic inflammation of the skin caused by poor circulation in the legs — that had not responded to standard treatments. Both patients also experienced significant psychological and social difficulties related to their condition. They were treated with injections directly into the skin of a combination of two substances: high-molecular-weight hyaluronic acid (a naturally occurring molecule known for its role in tissue hydration and repair) and succinic acid (a compound with anti-inflammatory properties). Each patient received two treatment sessions spaced one month apart.
This research suggests that this combination injection therapy was associated with significant improvements in both the skin condition and the patients' overall quality of life and psychological wellbeing. The first patient (77-year-old man) showed marked and sustained improvement at a 6-month follow-up. The second patient (75-year-old woman) showed substantial improvement after just the first session, near-complete resolution of skin lesions after the second session, and maintained remission at the 6-month follow-up. Neither patient experienced any reported side effects from the treatment.
This research is important because stasis dermatitis can be difficult to treat when it does not respond to conventional therapies, and it significantly impacts patients' daily lives and mental health. However, because this report only covers two patients, it is not possible to draw broad conclusions. The authors themselves note that larger, more rigorous studies are needed before this treatment approach can be more widely recommended. These findings nonetheless suggest a potentially promising avenue for patients whose stasis dermatitis has not improved with standard care.
Zhao Q, Zambrano M, Brito S, Bin B, Ran Y, Leguina-Ruzzi A. (2026). Refractory Stasis Dermatitis Due to Chronic Venous Insufficiency With Psychosocial Worsening in 2 Septuagenarian Patients Treated With Hyaluronic Acid-Succinic Acid Intradermotherapy.. The American journal of case reports. https://doi.org/10.12659/AJCR.953520