Case history
Case history #1
A 55-year-old man presents with a 6-month history of a large wound on his right lower leg. He has had chronically swollen legs for >10 years. He notes that his brother (deceased, myocardial infarction) and mother (deceased, pulmonary embolism) had similar problems in their legs. He had two documented episodes of deep vein thrombosis (DVT) in the affected leg 5 years earlier.
Case history #2
A 70-year-old woman presents with gradual, progressive leg swelling. She also has itching, occasional skin flaking, and darkness of the leg. The swelling gets worse as the day progresses. Various topical agents have provided little relief.
Other presentations
Patients with CVI may also present with superficial thrombophlebitis, which presents as localized pain, tenderness, and erythema in the involved area. Skin changes may be advanced in CVI patients with more severe disease (e.g., pigmentation, eczema, frank ulceration). The skin and subcutaneous tissues may also be fibrotic with brawny induration, a condition known as lipodermatosclerosis.
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