Risk Factors in Patients with Venous Stasis-Related Skin Lesions without Major Abnormalities on Duplex Ultrasonography

Abstract

Purpose: To clarify the risk factors for venous stasis-related skin lesions in the legs in patients without major abnormalities on duplex ultrasonography (DUS). Methods: Fifty patients (nine males and 41 females, age 27-93 years) with symptoms of C4 or greater according to the Clinical, Etiological, Anatomical, Pathological (CEAP) classification, but having no abnormalities on DUS were reviewed for known risk factors for chronic venous insufficiency (CVI) such as older age (>70 years), obesity (body mass index [BMI] >30 kg/m 2 ), short walking distance (<200 m/day), reduced ankle range of motion (<20°), and occupation requiring prolonged standing (>8h per day). Results: The risk factor was different between male and female patients; although all patients had at least one of the above risk factors, the most commonly found risk factor in male patients was occupation requiring prolonged standing (63%), while advanced age (78%) and limited walking distance (83%) were risk factors in female patients. Conclusions: Although male and female patients had different risk factors, insufficient walking seemed to be closely related to the development of venous stasis-related skin lesions.

Compression Therapy Using Bandages Successfully Manages Acute or Subacute Lipodermatosclerosis

“…These often-overlooked risk factors are significant and associated with development of chronic venous insufficiency (CVI). 7 , 8 )…”

Self-Care-Based Treatment Using Ordinary Elastic Bandages for Venous Leg Ulcers

“… 22 ) Therefore, it can be assumed that some patients with VLUs due to superficial and/or perforator vein insufficiency do not require life-long compression therapy. However, despite the absence of venous disorders in a duplex scan, other risk factors, such as occupations requiring prolonged standing periods, 5 ) obesity, and reduced ankle range of motion, 23 ) can lead to VLUs. VLU recurrence is always preceded by C3–4 symptoms described by the Clinical-Etiology-Anatomy-Pathophysiology classification.…”

“…Duplex ultrasonography (DUS) was performed in all patients. However, because venous ulcers can develop without showing any abnormality in DUS, 5 ) we regarded ulcers in the area of lipodermatosclerosis as those with a venous origin. In difficult cases, the diagnosis was made based on mutual agreement between us, dermatologists, and pathologists.…”

Comparative efficacy and safety of traditional Chinese medicine for lipodermatosclerosis

“…Lipodermatosclerosis (LDS), also known as Localized Scleroderma or Dermatosclerosis, is first described in 2009 as the C4b stage of varicose veins of the lower extremities by Shiman et al [ 1 ] Today, it is generally believe that LDS is a part of the pathological progress in the progression of chronic venous disease (CVD). [ 2 ] It is a non-bacterial inflammatory reaction of the skin and fat caused by the activation of leukocytes and inflammatory mediators under a background of venous hypertension. Its main clinical manifestations are erythema, induration, hyperpigmentation, and rough and thickened skin.…”