ORLANDO — Approximately half of limbs with varicose veins will have a skin complication, according to a retrospective study.
Venous disease affects an estimated 20% of women and 7% of men in the United States. Patients often present with one or more of these symptoms: aching, tiredness, heaviness in the legs, pain, cramping, swelling, itching, restless legs, and numbness, Ricardo Mejia, M.D., said at the annual meeting of the Florida Society of Dermatologic Surgeons.
Dr. Mejia and his colleague, Lawrence Tretbar, M.D., conducted a 10-month study of skin complications associated with venous disease. They assessed 113 limbs on 105 patients. Participants had surgery for incompetence of the great saphenous vein (102 limbs) or small saphenous vein (11 limbs). The age range was 23–83 years, and 78 of the participants were women. Approximately 50% of limbs (57 total) had skin findings, according to Dr. Mejia of Jupiter, Fla.
Men were 1.5 times more likely to present with dermatologic complications, although varicose veins are three times more common in women. Others at higher risk for skin manifestations include patients with advanced disease or of advanced age, and younger patients if they have a large saphenofemoral junction diameter (greater than 12 mm).
Clinical findings in the study included edema (32% of limbs), hyperpigmentation (24%), lipodermatosclerosis (13%), dermatitis (7%), atrophie blanche (4%), and lymphedema (1%).
In addition, 12% of participants developed ulcers. Venous ulcers are significantly more common than arterial ulcers, Dr. Mejia said. Venous ulcers tend to have a less necrotic base and are in general less painful than arterial ulcers.
In the study, “intractable” ulcers healed after vein stripping surgery, Dr. Mejia said. The treatment also softened lipodermatosclerosis and reduced edema. However, he added, half of the participants required continued compression.