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Anja Oelert, Manuela Kittel, Martin Hahn, Hermann Haase, Michael Jünger
In five patients who suffered from chronic venous insufficiency clinical stage C4 (n = 3) and C6 (n = 2) the capillary blood pressure was measured twice by means of invasive direct cannulation of nailfold capillaries of the toe. During one measurement course the patients wore below knee medical compression stockings (40 mmHg) during the other they did not have compression therapy. With the patient in supine position, the CP was investigated by the servo-nulling technique under resting conditions and under dynamic conditions: the calf-muscle/ankle joint venous pump was simulated by means of inflating a blood pressure cuff, which surrounded the mid lower leg, to 60 mmHg for 60 s...
April 7, 2018: Clinical Hemorheology and Microcirculation
Michael Lichtenberg, Rick de Graaf, Christian Erbel
Postthrombotic syndrome (PTS) is the most common complication after iliofemoral deep vein thrombosis. It reduces quality of life and increases deep vein thrombosis (DVT)-related costs. The clinical symptoms and severity of PTS may vary; the most common symptoms include edema, pain (venous claudication), hyperpigmentation, lipodermatosclerosis, and ulceration. PTS is based on the principle of outflow obstruction, which may be caused by venous hypertension and may lead to valvular damage and venous reflux or insufficiency...
March 8, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Adane Ayele, Michael J Tidman, Asok Biswas
Lipodermatosclerosis (LDS) is a well-recognized form of fibrosing panniculitis. Although chronic cases are readily diagnosed, early and evolving lesions may be clinically mistaken for cellulitis and other forms of panniculitis. Most pathologists are familiar with a pseudomembranous type of fat necrosis as a useful feature of chronic LDS. Although nonspecific, this distinctive pattern of fat necrosis helps in supporting a diagnosis of LDS in the appropriate clinical context. The histopathologic features of early and evolving LDS and those involving the dermis are less well documented...
September 5, 2017: Journal of Cutaneous Pathology
Sadhana Balasubramanyam, Michael R Migden, Sirunya Silapunt
No abstract text is available yet for this article.
August 29, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Mark R Wick
The diagnosis of panniculitis is felt to be a confusing topic by some pathologists. This summarical article presents inflammatory diseases of the subcutis in a systematic fashion, based on whether they are centered on fibrovascular septa or the adipose lobules, and whether morphologic vasculitis is present or not. Septocentric, non-vasculitis disorders include erythema nodosum, panniculitis that follows the use of "biological" therapeutic agents, lipodermatosclerosis, post-irradiation panniculitis, morphea profunda, and necrobiosis lipodica profunda...
May 2017: Seminars in Diagnostic Pathology
C A Hinojosa, S Olivares-Cruz, H Laparra-Escareno, S Sanchez-Castro, B Tamayo-Garcia, J E Anaya-Ayala
OBJECTIVE: Post-thrombotic syndrome (PTS) is the long-term sequelae of deep venous thrombosis (DVT). PTS clinical manifestations include chronic leg pain, oedema, lipodermatosclerosis and ulcers. The objective of this study is to determine in patients with documented history of thrombophilias and DVT whether the number of previous thrombotic events and optimal anticoagulation therapy are associated with the time to venous ulcer healing following the start of compression therapy. METHOD: Retrospective analysis performed in thrombophilic patients under the age of 50 years old with chronic venous ulcers secondary to DVT at the wound clinic in the National Institute of Medical Sciences and Nutrition 'Salvador Zubirán ' in Mexico City...
December 2, 2016: Journal of Wound Care
Massimo Papi
Lipodermatosclerosis may develop clinical aspects that have striking analogies with Van Gogh's style of painting cypresses. They may reveal specific physiopathological disorders and identify a homogeneous group of patients with chronic venous insufficiency.
December 2016: International Journal of Lower Extremity Wounds
Derek Ho, Eve J Lowenstein
Case 1 A 60-year-old African American man presented with a medical history of morbid obesity (weighing more than 550 lb), benign prostatic hyperplasia, hyperlipidemia, gynecomastia, atrial fibrillation, hypertension, chronic obstructive pulmonary disease, psoriasis, sleep apnea, and cardiomegaly. His size has limited his ability to clean himself properly. He experiences chronic and recurrent skin irritation and cellulitis possibly secondary to intertriginous superinfection, lymphedema, and venous stasis. On examination, his abdomen showed heavy skinfolding with hyperpigmentation, cobblestone and velvety changes, thickening and fibrotic induration of the skin, focal areas of redness, and tenderness on palpation (Figure 1A and 1B)...
2016: Skinmed
Gábor Martis
No abstract text is available yet for this article.
December 2016: Phlebology
Mark S Whiteley
No abstract text is available yet for this article.
December 2016: Phlebology
P O E Nelzén, J Skoog, C Lassvik, T Länne, H Zachrisson
OBJECTIVE/BACKGROUND: To evaluate whether the outcome of radiofrequency ablation (RFA) treatment of great saphenous vein (GSV) incompetence may be predicted using strain-gauge plethysmography (SGP) with selective occlusion of the superficial venous system. METHODS: Seventeen patients (20 limbs) underwent endovenous RFA treatment for GSV incompetence (Clinical Etiology Anatomy Pathophysiology classification C2-C5; "C-group"). Duplex ultrasound (DUS) and SGP were performed with selective occlusion of superficial veins before and after RFA...
September 2016: European Journal of Vascular and Endovascular Surgery
Alejandro González Ochoa
BACKGROUND: In the treatment of venous leg ulcers, vasoactive drugs such as diosmin-hesperidin micronized purified flavonoids (DH) and, more recently, sulodexide (SDX), have been used besides compression therapy and local measures. The purpose of this study was to investigate whether the combined administration of both SDX and DH is better than DH alone in the treatment of venous ulcers. METHODS: In an open-label, observational, non-parallel trial, 70 patients (90 venous ulcers) were treated with multi-layer bandaging, local measures and DH, 37 patients (50 ulcers) also received SDX, 33 patients (40 ulcers) without SDX were the control group...
February 2017: International Angiology: a Journal of the International Union of Angiology
Anthonia Asanye Ikpeme, Usang Edet Usang, Akan Wilson Inyang, Nchiewe Ani
AIM: This is to report a case of Klippel Trenauay Weber syndrome in a fifteen year old Nigerian boy. This is a rare syndrome and it is the first case to be reported in UCTH Calabar. CASE PRESENTATION: Product of a full term uneventful pregnancy, delivered to non-consanguineous apparently healthy parents. At birth was noted to gradually develop swelling on the right leg, worse at the right foot. There was crossed hemi-hypertrophy with right leg bigger than the left...
June 15, 2015: Open Access Macedonian Journal of Medical Sciences
Gábor Martis, Renáta Laczik
Aim Analysis of the radical removing of the dermatosclerotic tissues and ulcer(s) with perforator veins dissection as well as local wound and standard compression treatment of CEAP C5/6 stage in a prospective comparative cohort study. Primary endpoint is to compare the results of the one-year follow-up regarding quality of life, vein clinical severity score, and ulcer healing process. Secondary endpoint is the precise presentation of the surgical technique. Tertiary endpoint is to demonstrate the photo-documented results of the postoperative wound treatment protocol...
December 2016: Phlebology
Albert-Adrien Ramelet, Vincent Crebassa, Carlos D Alotto, Guillermo Buero, Jean-Luc Gillet, Anne Grenot-Mercier, Stefan Küpfer, Erika Mendoza, Jean-Michel Monsallier, Alfred Obermayer, Kenedy Pacheco, Nicolas Pros, Didier Rastel, Dominique Soulié
Objectives Anomalous intraosseous venous drainage is a rare and almost unknown entity; only 14 cases have been reported in the literature and 4 mentioned in textbooks. We report the characteristics of 35 further cases observed in 32 patients. Method After the presentation of two cases at the congress of the French Society of Phlebology in Paris (2013), 12 colleagues joined to present a large series of so-called bone perforators observed in their practice, all identified with at least a duplex investigation...
May 2017: Phlebology
W James Tidwell, Janine Malone, Jeffrey P Callen
No abstract text is available yet for this article.
April 2016: JAMA Dermatology
Elizabeth McVittie, Samantha Holloway
The presence of chronic venous insufficiency results in venous hypertension, which can lead to the development of venous leg ulceration. Patients often present with oedema of the lower limb and skin changes, for example, the presence of haemosiderin and lipodermatosclerosis, as well as ulceration. In some instances, patients can also develop atrophie blanche (AB)-white fibrotic areas on the skin adjacent to the ulcer. AB remains an ambiguous term owing to the use of many synonyms. Hence, health professionals need to be aware of the clinical presentation of AB and should be able to clearly differentiate between scarring caused by previous ulcers and that caused by the presence of AB...
December 2015: British Journal of Community Nursing
Johanna A Knipper, Sebastian Willenborg, Jürgen Brinckmann, Wilhelm Bloch, Tobias Maaß, Raimund Wagener, Thomas Krieg, Tara Sutherland, Ariel Munitz, Marc E Rothenberg, Anja Niehoff, Rebecca Richardson, Matthias Hammerschmidt, Judith E Allen, Sabine A Eming
Activation of the immune response during injury is a critical early event that determines whether the outcome of tissue restoration is regeneration or replacement of the damaged tissue with a scar. The mechanisms by which immune signals control these fundamentally different regenerative pathways are largely unknown. We have demonstrated that, during skin repair in mice, interleukin-4 receptor α (IL-4Rα)-dependent macrophage activation controlled collagen fibril assembly and that this process was important for effective repair while having adverse pro-fibrotic effects...
October 20, 2015: Immunity
Michele Ruggiero, Raffaele Grande, Agostino Naso, Lucia Butrico, Paolo Rubino, Girolamo Domenico Placida, Marco Cannistrà, Raffaele Serra
Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition...
October 2016: International Wound Journal
Atsushi Tabuchi, Hisao Masaki, Kazuo Tanemoto
Surgical treatment of severe varicose veins (CEAP classification : C4b-C6) should involve not only interruption of incompetent superficial veins to prevent venous regurgitation due to valve incompetence but also interruption of incompetent perforator veins. Subfascial endoscopic perforator vein surgery (SEPS) is performed via a small skin incision and involves interruption of perforator veins by the insertion of an endoscope into the subfascial space. SEPS produces good surgical outcomes: it is accurate in detecting and transecting perforator veins; has a low frequency of surgical wound complications; prevents lipodermatosclerosis and formation of pigmented skin lesions; and is minimally invasive compared with Linton's operation...
May 2015: Nihon Geka Gakkai Zasshi
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