Progression of varicose veins and CVI can result in the development of more severe signs and symptoms and is seen in up to 10% of the population. It is more common in the older population [3]. Often, they require treatment of both the underlying disease and the complications of CVD.
Corona phlebectatica paraplantaris – a cluster of telengectasia and reticular veins distal to the malleoli, around the heal and ankle, often the initial indicator of progression to chronic venous insufficiency.
Venous Oedema perceptible increase in the volume of fluid in the subcutaneous tissue and skin, characterised by indentation or pitting of the skin. Commences at the ankle and progresses proximally towards the knee as the disease progresses.
Skin Changes due to Chronic Venous Disease (in order of severity of CVD)
Haemosiderosis or pigmentation of the skin of the ankle and leg due to the extravasation and breakdown of red blood cells into the skin/subcutaneous tissues. This does not reverse if the CVI is treated.
Venous eczema is erythematous dermatitis that can progress to blistering, weeping or scaling eruption of the skin of the leg. Also called stasis dermatitis it is characterised by permanent skin changes including thickening, hardening and darkening of the skin giving a cobblestone like appearance.
Lipodermatosclerosis is the localised chronic inflammation and fibrosis of the subcutaneous tissues and skin of the leg resulting in scarring and contracture of the tendons. Also referred to as Champagne-shaped Leg due to changes in the visual shape of the affected leg. It can be preceded by diffuse inflammatory oedema of the legs called hypodermitis.
Atrophie blanche is the localised areas of circular whitish atrophic skin surrounded by dilated capillaries and hyperpigmentation. This should not be confused with pigmented atrophic scarring from healed venous ulcers.
Venous ulcer full-thickness skin defect, commonly around the ankle region, or an open wound from other trauma that fails to heal spontaneously (commonly a timeline of 3 months is applied before it is defined as an ulcer).
Healing venous ulcer with chronic venous change (haemosiderosis)