Summary
Objective: To conduct a longitudinal vein study in a young study population on when and how varicose veins develop in healthy veins. Population, method: The initial study population consisting of pupils aged 10–12 (BO I, n = 740) underwent clinical and ultrasound follow-up at the ages of 14–16 (BO II, n = 518), 18–20 (BO III, n = 459) and 29–31 (BO IV, n = 136). During BO I-IV all venous findings detected (including preclinical refluxes of the saphenous veins) were recorded. Results: The data were broken down to reveal the incidence and prevalence of venous refluxes (VR), varicose veins (VV) and venous abnormalities (VA) for each part of the study. Furthermore, the data were analyzed longitudinally to identify any correlations between VR and VV in the two saphenous veins. Conclusions: Since none of the study subjects exhibited VV during BO I, the study permits evaluation of the venous situation in the subjects from birth on. The manifestation of a truncal VV is preceded by a VR in the same vein (p = 0.039). VR occurred mainly during puberty (BO I: 2.5%, BO III: 18.5%, BO IV: 25%). A preclinical VR represents a 30% risk (95% CI: 13–53%) of developing a truncal VV within four years, as a consequence, subsequent preventive 2-year follow-up examinations are recommended.
To our knowledge, this is the first time the physiologic changes of venous calf pump function have been documented in a longitudinal study in young volunteers with healthy veins. The median venous refilling time successively lengthened, corresponding to a maturing of the venous calf pump function during adolescence and then stayed on a stable level. Therefore, measurements of venous calf pump function are not a means for assessing malfunction of the venous system during childhood and adolescence.
A 36-year-old female patient was treated with PUVA for dyshidrotic eczema that had not shown sufficient response to topical therapy over the previous months. PUVA therapy caused acute aggravation of the eczema. Patch testing demonstrated Type IV sensitization to 8-methoxypsoralen in Meladinine solution.
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