Characteristic skin changes in CVI

Summary

In routine phlebological practice CVI is often diagnosed by inspection of the skin changes that typically accompany the various stages. This is then confirmed and specified by further diagnostic instrumentation before deciding on case management. The clinical appearance plays a significant role, particularly in view of the two most common staging schemes for CVI (acc. to Widmer, and the CEAP classification). This article gives an overview of the characteristic skin changes seen in the different stages of CVI, and is intended to train the clinician’s eye for diagnosing CVI.

Keywords

Varicosis - chronic venous insufficiency - CVI - skin changes - venous ulcer

• References

• 1 Busch Ch, Schnabl S, Strölin A. Endokrine Mechanismen in der Pathogenese der primären Varikose. Phlebologie 2013; 42: 13-18.
• 2 Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health 1999; 53: 149-153.
• 3 Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of the lower extremities: the „CEAP“ classification. Mayo Clin Proc. 1996; 71: 338-345.
• 4 Maffei FH, Magaldi C, Pinho SZ, Lastoria S, Pinho W, Yoshida WB, Rollo HA. Varicose veins and chronic venous insufficiency in Brazil: prevalence among 1755 inhabitants of a country town. Int J Epidemiol 1986; 15: 210-217.
• 5 Meissner MH, Gloviczki P, Bergan J, Kistner RL, Morrison N, Pannier F, Pappas PJ, Rabe E, Raju S, Villavicencio JL. Primary chronic venous disorders. J Vasc Surg 2007; (Suppl. 46) 54S-67S.
• 6 Meissner MH, Moneta G, Burnand K, Gloviczki P, Lohr JM, Lurie F, Mattos MA, McLafferty RB, Mozes G, Rutherford RB, Padberg F, Sumner DS. The hemodynamics and diagnosis of venous disease. J Vasc Surg 2007; (Suppl. 46) 4S-24S.
• 7 Nees S, Juchem G, Weiss DR, Partsch H. Pathogenesis and therapy of chronic venous disease: New insights into structure and function of the leg venous system. Phlebologie 2012; 41: 246-257.
• 8 Somers P, Knaapen M. The histopathology of varicose vein disease. Angiology 2006; 57: 546-555.
• 9 Widmer LK, Kamber V, da Silva A, Madar G. [Overview: varicosis (author’s transl)]. Langenbecks Arch Chir 1978; 347: 203-207.