Varicosities (Varicose Veins) Either small or larger vessels [1] First indicator of chronic venous insufficiency is often the presence of a dilated long saphenous vein on the medial aspect of the calf Hemosiderin staining Brown or brownish red pigmentation and purpura (purplish discoloration of the skin produced by small bleeding vessels near the surface) [2] Caused by extravasation (leaking) of red blood cells into the dermis Insoluble form of storage iron collects within the macrophages and melanin deposition occurs Will not disappear over time (internal cause) Chronic Lipodermatosclerosis Lower 1/3 of leg becomes sclerotic (hardened and woody. tissue) Leg becomes champagne bottle or bowling-pin shaped [2] Venous ulcers surrounded by extensively fibrotic skin (excess connective tissue ) Ulcers are more difficult to heal lipodermatosclerosis Hyperpigmentation and hypopigmentation interspersed with telengectasia or tiny blood vessels on the surface [3] Painful and tender panniculitis (inflammation of adipose tissue) Ulcers can occur within the lesion Becomes intensely fibrotic over time [2] Stasis (venous) dermatitis Erythema Scaling Pruritis (itchy) Sometimes weeping May develop cellulitis - portal of entry small breaks in the skin Atrophie blanche Located on the or foot Ivory white lesions, atrophic plaques [2] Caused by scarring from previous injuries Ulcerations in of atrophie blanche tend to be exquisitely painful Woody fibrosis [2] deposits of fibrin in the deep dermis and fat results in a woody induration of the gaiter area (lower 1/3 of calf) of the leg peri-wound skin is often hardened and indurated, may be thickened
Varicosities (Varicose Veins) Either small or larger vessels First indicator of chronic venous insufficiency is often the presence of a dilated long saphenous vein on the medial aspect of the calf [1] Hemosiderin staining Brown or brownish red pigmentation and purpura (purplish discoloration of the skin produced by small bleeding vessels near the surface) Caused by extravasation (leaking) of red blood cells into the dermis Insoluble form of storage iron collects within the macrophages and melanin deposition occurs Will not disappear over time (internal cause) [2] Chronic Lipodermatosclerosis Lower 1/3 of leg becomes sclerotic (hardened tissue) and woody. Leg becomes champagne bottle or bowling-pin shaped Venous ulcers surrounded by extensively fibrotic (excess connective tissue ) skin Ulcers are more difficult to heal [2] lipodermatosclerosis Hyperpigmentation and hypopigmentation interspersed with telengectasia or tiny blood vessels on the surface Painful and tender panniculitis (inflammation of adipose tissue) Ulcers can occur within the lesion Becomes intensely fibrotic over time [3] Stasis (venous) dermatitis Erythema Scaling Pruritis (itchy) Sometimes weeping May develop cellulitis - portal of entry small breaks in the skin [2] Atrophie blanche Located on the or foot Ivory white lesions, atrophic plaques Caused by scarring from previous injuries Ulcerations in of atrophie blanche tend to be exquisitely painful [2] Woody fibrosis deposits of fibrin in the deep dermis and fat results in a woody induration of the gaiter area (lower 1/3 of calf) of the leg peri-wound skin is often hardened and indurated, may be thickened [2]
Venous%20and%20Mixed%20Venous%20Leg%20Ulcers.docx