Cutaneous findings in patients with chronic venous insufficiency

Abstract

Background Venous hypertension causes many different cutaneous findings such as varicosities, telangiectasia, edema, and pigmentation, dermatitis, and venous ulcers on the skin. Objective This study aims to investigate the cutaneous signs and symptoms of chronic venous insufficiency (CVI) and to examine their contribution to early diagnosis. Methods A total of 150 patients were included in the study who applied to the dermatology outpatient clinic and were diagnosed with skin disease related to CVI or had skin findings. Patient's age, gender, complaints, occupation, additional diseases, drug usage, history of prolonged standing and travel, smoking habit, number of pregnancies, history of varicose veins in the family, dermatological diagnosis/findings, and venous Doppler ultrasonography reports were examined retrospectively. Results 56% of patients were women. Mean age was 56.69 ± 13.6 years. Overall, 82.7% of total patients had at least one skin finding. The most frequent skin findings except varicose veins were insufficiency dermatitis accounted for 32.7% of patients, telangiectasia, and pigmentation which were comprised 25.3%, 19.3% of the total number of patients respectively. In addition to this, 48.7% of patients had itching problems and 32.7% had pain. Moreover, 46% of patients presented superficial vein insufficiency, while 8.7% had deep vein insufficiency. For 47.3% of patients, vein diameter dilation was observed and 11.3% suffered from perforating vein insufficiency. In terms of Clinical‐Etiologic‐Anatomic‐Pathophysiologic (CEAP) classification, scores of 52% of the patients were C3 and lower, while scores of 48% of total patients were C4a and higher. Conclusions Early diagnosis and treatment of chronic venous insufficiency could prevent further chronic processes such as venous ulceration which is an advanced CVI finding. Thus, assessing the early skin findings might be important to identify the underlying venous insufficiency disease.

Effects of a Dietary Supplement Composed of Baicalin, Bromelain and Escin for Venous Chronic Insufficiency Treatment: Insights from a Retrospective Observational Study

“…Tiwary et al [ 50 ] observed pigmentation and eczema in 24% of cases and stated that the severity of the disease increased with the severity of the pigmentation. Moreover, according to a recent study, pigmentation (19.3%) was identified as one of the most common skin findings observed in patients with CVI, diabetes, hyperlipidemia, and thyroid disease [ 51 ]. In our study, 40.3% and 41.9% of patients had a severe and moderate SP score, respectively.…”

Diagnostik und Therapie des Ulcus cruris venosum: S2k‐Leitlinie der Deutschen Gesellschaft für Phlebologie und Lymphologie (DGPL) e.V.

“…Neben Stauungsdermatitis sind es beispielsweise asteatotische Ekzeme oder allergische Kontaktekzeme. 73 Die Prävalenz relevanter Kontaktsensibilisierungen ist bei Patienten mit UCV erhöht, so dass bei entsprechendem Verdacht eine weiterführende Diagnostik mit Epikutan-Testungen und/oder repetitivem offenem Applikationstest (ROAT) erfolgen sollte. 74,75 Patientenedukation und Selbstmanagement Das Wissen um die eigene Erkrankung und grundlegende Kenntnisse der Behandlung einschließlich deren durchzuführende Maßnahmen sowie der dabei zum Einsatz kommenden Materialien, ermöglicht den Patienten mit UCV ein besseres Therapieverständnis zu entwickeln und fördert somit die Adhärenz.…”

Diagnosis and treatment of venous leg ulcers: S2k Guideline of the German Society of Phlebology and Lymphology (DGPL) e.V.

“…Apart from stasis dermatitis, these include asteatotic eczemas or allergic contact eczemas. 73 Given the increased prevalence of relevant contact sensitizations in patients with VLU, advanced diagnostics with patch testing and/or repeated open application test (ROAT) should be performed in case of suspicion. 74,75 Patient education and self-management Knowledge about their own disease and basic knowledge about the treatment, including the measures to be taken and the materials utilized for this purpose, enables patients with VLU to develop a better understanding of the therapy and thus promotes adherence.…”