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Fitzpatrick Dermatology Atlas
| Part II. Dermatology and Internal Medicine > |
Chronic Venous Insufficiency
Sections: Epidemiology and Etiology, Etiology, Aggravating Factors, Pathogenesis, Clinical Manifestation, Skin Lesions, Varicose Veins, Edema, Eczematous (Stasis) Dermatitis, Atrophie Blanche, Lipodermatosclerosis, Ulceration, Laboratory Examinations, Doppler and Color-Coded Duplex Sonography, Phlebography, Imaging, Dermatopathology, Diagnosis, Management, Prerequisite, Atrophie Blanche, Stasis Dermatitis, Varicose Veins, Injection Sclerotherapy, Vascular Surgery, Endovascular Techniques, Venous Ulcers.
Excerpt:
"Varicose veins: peak incidence of onset 30–40 years. Varicose veins are three times more common in women than in men.CVI is most commonly associated with varicose veins and the postphlebitic syndrome. Varicose veins are an inherited characteristic.Superficial leg veins are enlarged, tortuous, with incompetent valves; best evaluated with the patient standing (Fig. 16-7A). "Blow-out" at sites of incompetent communicating veins. Tourniquet test: A tourniquet is applied to the leg that has been elevated to empty the veins; when the patient stands up and the tourniquet is released, there is instant filling of a varicose vein due to absent or ill-functioning valves. Varicose veins may or may not be associated with starburst phlebectasia usually overlying the area of an incompetent communicating vein (Fig. 16-7B). These small venectasias per se have no pathogenic significance but are of cosmetic concern to the patient. Superficial venectasias (spider phlebectasia) without a starburst pattern occur also and far more commonly without CVI, usually on the thighs and lateral lower legs in women.
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