Superficial thrombophlebitis is a thrombosis and inflammation of superficial veins which presents as a painful induration with erythema, often in a linear or branching configuration forming cords. : 826–7 Superficial thrombophlebitis is due to inflammation and/or thrombosis, and less commonly infection of the vein. It is generally a benign, self-limited disorder, however, it can be complicated by deep vein thrombosis (DVT) and even pulmonary embolism (PE) Migratory superficial thrombophlebitis is known as Trousseaus syndrome. Signs and symptoms
Findings of tenderness, induration, pain and/or erythema along the course of a superficial vein usually establish a clinical diagnosis, especially in patients with known risk factors. In addition, there is often a palpable, sometimes nodular cord, due to thrombus within the affected vein. Persistence of this cord when the extremity is raised suggests the presence of thrombus. Complications
Superficial vein thrombosis extension to the deep vein system and/or recurrence of SVT. Suppurative thrombophlebitis is suspected when erythema extends significantly beyond the margin of the vein and is likely to be associated with significant fever. If suspected, antibiotic treatment, surgical drainage and potentially vein excision are indicated.Venous thromboembolism can occur with superficial vein thrombosis. Estimates of the percentage of patients with SVT who also have DVT vary between 6% and 53%, and symptomatic pulmonary embolism has been reported in 0% to 10% of patients with SVT. Risk factors
Patient characteristics and predisposing factors for thrombophlebitis nearly mirror those for DVT; thrombophlebitis is a risk factor for the development of DVT, and vice versa.
Fluocinonide (sold under various trade names) is a potent glucocorticoid used topically as an anti-inflammatory agent for the treatment of skin disorders such as eczema and seborrhoeic dermatitis. It relieves itching, redness, dryness, crusting, scaling, inflammation, and discomfort. The usual prescription concentration is 0.05% as a topical cream, ointment, solution, or gel. The application area should normally not be covered after application. In certain cases, the physician may recommend the use of an occlusive dressing after application to increase the rate and depth of absorption. The frequency of application depends on the condition being treated and the area affected, but most often it should be applied 2 to 4 times a day.Fluocinonide ranks as a "high-potency" (second-highest rank) topical corticosteroid. Minimal amounts should be used for a minimal length of time to avoid the occurrence of adverse effects.Fluocinonide should not be used if infection is present. It should not be applied to the eyes or to sensitive areas such as the genitals or anus.A common potential adverse effect is skin atrophy (thinning of the skin). Systemic absorption of topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal axis (HPA) suppression, manifestations of Cushings syndrome, hyperglycemia, and glucosuria in some patients. Fluocinonide should be used with caution when treating children, pregnant women, nursing mothers, and anyone using the medication for longer than two weeks. Fluocinonide is used in veterinary medicine. It is a treatment for allergies in dogs. Natural systemic cortisol concentrations can be suppressed for weeks after one week of topical exposure.