Superficial (nodular) thrombophlebitis as a heterogeneous entity with distinctive clinico-pathological aspects: Correlation with the underlying conditions

J Eur Acad Dermatol Venereol. 2023 Feb;37(2):436-442. doi: 10.1111/jdv.18630. Epub 2022 Oct 17.


Background: Superficial (nodular) thrombophlebitis, referring to a thrombo-inflammatory disorder of dermal-subcutaneous veins, encompass a spectrum of nodular lesions often associated with inflammatory, infectious, neoplastic or thrombophilic diseases.

Objective: We postulate that distinct clinico-pathological features may correlate with the underlying conditions.

Methods: We conducted a retrospective monocentric study of all patients seen in our dermatology department for a superficial thrombophlebitis, completed with a literature review. Clinical and pathological data were extracted from the patient files and articles.

Results: A total of 108 cases of superficial thrombophlebitis was analysed. Forty-five percent manifested as elongated nodules clearly evoking vascular involvement, while the other 55% were presenting as nodules or plaques. The elongated phenotype was strongly associated with malignancy or thrombophilia if a pure thrombosis was demonstrated histopathologically, while tuberculosis was the main underlying condition if a granulomatous vasculitis was present. Panniculitis-like lesions were mainly corresponding to erythema-nodosum-like lesions of Behçet's disease, characterized by the distinctive feature of thrombotic veins with an associated leukocytoclastic vasculitis.

Limitations: Retrospective design and risk of publication bias.

Conclusion: Superficial (nodular) thrombophlebitis is a heterogeneous entity with a distinct clinico-pathological presentation that strongly points to the nature of the underlying medical condition, thus guiding the medical workup.

Publication types

  • Review

MeSH terms

  • Erythema Nodosum* / complications
  • Humans
  • Panniculitis* / complications
  • Retrospective Studies
  • Thrombophlebitis* / complications
  • Thrombophlebitis* / pathology
  • Tuberculosis* / complications