Sequelae of untreated venous insufficiency

Abstract

Untreated venous insufficiency results not only in a gradual loss of cosmesis but also in variety of complications including persistent pain and discomfort, hemorrhage, superficial thrombophlebitis, and progressive skin changes that may ultimately lead to ulceration. In rare instances, chronic soft tissue changes may lead to stiffness of the ankle joint, fixed plantar flexion, and periostitis. This article reviews the variety of complications caused by venous insufficiency.

Keywords: Venous insufficiency; varicose veins complications; venous; venous ulcers.

Figure 1

Unsightliness of varicosities is a common cause of self-referral.

Figure 2

Cutaneous telangiectasias.

Figure 3

Arborizing telangiectasia. These intradermal veins may gradually spread over both lower legs, turning them purplish in color.

Figure 4

Pitting edema.

Figure 5

Superficial thrombophlebitis.

Figure 6

Hemorrhage.

Figure 7

Possible mechanism of ulceration in chronic venous insufficiency. (Adapted from Falanga V. Chronic wounds: pathophysiologic and experimental considerations. Prog Dermatol 1992;26:1–8.)

Figure 8

Pigmentation from hemosiderin deposition.

Figure 9

Lipodermatosclerosis is noted in the margins of the ulcer. Constriction of the gaiter distribution is also noted, causing bottle deformity of the leg.

Figure 10

Atrophie blanche. White scars appear in a larger area of chronic skin changes.

Figure 11

Periosteal new bone formation underneath an area of recurrent ulceration.