Ecchymosis: A novel sign in patients with varicose veins.

BACKGROUND: In the absence of trauma, hematologic disease and anti-platelet use, no attention has been paid to elucidate the mechanism of ecchymosis. It has taken our attention that ecchymosis on lower limb might be a sign of varicose vein. Accordingly, we aimed to analyze and describe the frequency of leg symptoms and presence of ecchymosis in patients with varicose vein.

MATERIALS AND METHODS: Four hundred and ninety four patients who had been diagnosed as having varicose vein or chronic venous insufficiency either by clinical examination or Doppler ultrasonography were included in the study. Leg symptoms were defined as pain, itching, muscle cramps, throbbing, and swelling. Ulcers, pigmentations and ecchymosis were recorded as signs of varicose vein. Ecchymosis was defined as a hemorrhagic lesions, larger than >3 mm on the skin of lower extremities, forming a flat, rounded or irregular, blue or purplish patch.

RESULTS: Leg pain was the most common symptom in our study population. Ecchymosis was observed in 24 patients (5%). Logistic regression analysis showed that ecchymosis was significantly and positively associated with muscle cramps (Odds ratio: 5.82, p = 0.001) and female gender (Odds ratio: 5.17 p = 0,019 but negatively associated with age (Odds ratio: 0.94, p = 0.004).

CONCLUSION: We have documented for the first time that the frequency of ecchymosis and its association with muscle cramps in a relatively large patient population with peripheral varicose vein or chronic venous insufficiency. Ecchymosis on lower limbs should be considered as a novel sign of varicose vein.