Seasonal variations in the onset and healing rates of venous leg ulcers

Abstract

Venous ulcers exhibit circannual fluctuations in their onset and healing rates. Hypothetically, in addition to exacerbation of chronic venous insufficiency, seasonal variations in immune system activity might potentially be responsible for this phenomenon.

Relationship between the seasonal onset of chronic venous leg ulcers and climatic factors

“…These results are concordant with previous reports which have indicated seasonal differences in the onset of chronic venous leg ulcers 4,5 . For example, Heede et al.…”

“…It is thought that venous reflux penetrates into the venules of the skin, leading to chronic venous ambulatory hypertension which subsequently may result in the onset of leg ulcerations 6 . Because CVI is typically exacerbated at higher temperatures, a peak in the frequency of chronic venous leg ulcers might be expected during the warmer summer months 5 . In our own clinical experiences, ulcer onset, in our patients with chronic leg ulcers, did not appear to correlate with higher temperatures.…”

“…One relevant aspect is the postsynaptic alpha‐2 adrenoceptors of the vascular smooth muscle, which are highly sensitive to temperature and locally lose their reactivity if the temperature increases 19 . Therefore venous reflux may increases at higher temperature and penetrates into the venules of the skin, leading to chronic venous ambulatory hypertension, a central aspect in the onset of leg ulcerations 5,6 . Because of that a peak in the frequency of chronic venous leg ulcers might be expected during summer months which do not correlate with our clinical experience.…”

“…Further problems are restrictions in work capacity, recreation, social interaction and psychological well being 3 . Previous reports have indicated seasonal differences in the onset of chronic venous leg ulcers, but the results were heterogeneous and the reasons for the seasonal fluctuations are still not well understood 4,5 …”

Data-driven discovery of seasonally linked diseases from an Electronic Health Records system

“…These breakthrough findings have suggested that the thus far unidentified causative pathogen may be a windborne microbe. Other groups have sought to confirm anecdotal findings of seasonal or climate related changes in disease rates, including heart failure [5], depression and anxiety [6], varicose vein ulcers [7], urinary tract infection [8,9], and even cancer [10]. While some of these works searched for seasonality using purpose-driven surveys, Upshur [11] used coded administrative data derived from a large EHR system to investigate whether seasonal peaks in incidence were a common feature in a limited set of the most frequent diagnoses.…”