Complications
Secondary to changes in the microcirculatory system, with the capillaries becoming elongated, fibrotic, and leaky.
Hyperpigmentation (usually a reddish-brown discoloration) of the ankle and lower leg is also known as brawny edema. It results from extravasation of blood and deposition of hemosiderin in the tissues due to long-standing ambulatory venous hypertension.
Increased dilation of the venous system and increased pressure may lead to venous hypertension. The typical constellation of findings that ensue include edema, lipodermatosclerosis, and eventual ulceration. Perforator incompetence may also contribute to ulceration.
Treatment of the superficial axial system, if involved, will help.[30] Perforator treatment is considered if perforating veins are involved.
Secondary to changes in the microcirculatory system, with the capillaries becoming elongated, fibrotic, and leaky. Characteristically results from capillary proliferation, fat necrosis, and fibrosis of the skin and subcutaneous tissues.
Erosion of varices can lead to bleeding that may require surgical intervention.
Uncommon in patients adherent with compression therapy, and good skin care and hygiene. Only consider treatment of a leg ulcer with antibiotics if there are clinical signs of infection. Do not routinely swab leg ulcers because colonization without infection is common. Follow local guidelines for antibiotic treatment, and make a specialist referral in patients with multiple comorbidities, and where there is suspicion of antimicrobial resistance, osteomyelitis, sepsis, or necrotizing fasciitis.[46]
Use of this content is subject to our disclaimer