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A venous ulcer tends to occur on the medial side of the leg, typically around the medial malleolus in the 'gaiter area' whereas arterial ulcer tends to occur on lateral side of the leg and over bony prominences. A venous ulcer is typically shallow with irregular sloping edges whereas an arterial ulcer can be deep and has a 'punched out' appearance.
Stasis dermatitis is diagnosed clinically by assessing the appearance of red plaques on the lower legs and the inner side of the ankle. Stasis dermatitis can resemble a number of other conditions, such as cellulitis and contact dermatitis, and at times needs the use of a duplex ultrasound to confirm the diagnosis or if clinical diagnosis alone is not sufficient.
Venous ulcers are common and very difficult to treat. Chronic venous ulcers are painful and debilitating. Even with treatment, recurrences are common if venous hypertension persists. Nearly 60% develop phlebitis which often progresses to deep vein thrombosis in more than 50% of patients. The venous insufficiency can also lead to severe hemorrhage.
This valvular incompetence combined with persistent venous obstruction from thrombus increases the pressure in veins and capillaries. Venous hypertension induces a rupture of small superficial veins, subcutaneous hemorrhage [7] and an increase of tissue permeability. That is manifested by pain, swelling, discoloration, and even ulceration. [8]
Livedoid vasculopathy (LV) is an uncommon thrombotic dermal vasculopathy that is characterized by excruciating, recurrent ulcers on the lower limbs. [4] Livedo racemosa, along with painful ulceration in the distal regions of the lower extremities, is the characteristic clinical appearance.
Venous eczema (gravitational eczema, stasis dermatitis, varicose eczema) occurs in people with impaired circulation, varicose veins, and edema, and is particularly common in the ankle area of people over 50. There is redness, scaling, darkening of the skin, and itching. The disorder predisposes to leg ulcers. (ICD-10 I83.1)
Potential complications of venous stasis are: Venous ulcers; Blood clot formation in veins (venous thrombosis), that can occur in the deep veins of the legs (deep vein thrombosis, DVT) or in the superficial veins; Id reactions [1]
437.6 Nonpyogenic thrombosis of intracranial venous sinus; 437.7 Transient global amnesia; 438 Late effects of cerebrovascular disease. 438.0 Cognitive deficits; 438.1 Speech and language deficits. 438.10 Speech and language deficits, unspecified; 438.11 Aphasia; 438.12 Dysphasia; 438.19 Other speech and language deficits; 438.2 Hemiplegia ...