Dermoscopic findings in chronic venous insufficiency

Abstract

Background: Chronic venous insufficiency (CVI) causes cutaneous changes. This prospective observational study reveals dermoscopic findings in CVI.

Methods: Successive CVI patients of ≥18 years were included in the study. American Venous Forum classification for CVI was utilized. All underwent clinical examination, duplex ultrasound, and dermoscopy. Pregnancy, pedal edema, or pigmentation from causes other than CVI, active/healed venous ulcers, prior venous interventions, arterial insufficiency, and deep vein thrombosis were excluded.

Results: Eighty patients were studied. Fifty-six were males [mean age of 58.9 years (SD-12.09)], and twenty-four were females [mean age of 53.9 years (SD-12.8)]. Sixty-two had bilateral, and eighteen had one limb involvement (total 142 limbs). Pigmentation was observed in 120 limbs, varicose veins in 138 limbs, eczema in 45, and edema in 33 limbs. On dermoscopy, the pigment network was accentuated and diffuse in 105 limbs and accentuated but patchy in 16 limbs. Vessel morphology noted were dotted vessels in 67 limbs, linear curved vessels in 45 limbs, linear curved vessels with branches in 11 limbs, and linear vessels in 7 limbs. Scales were white and diffuse in 56 limbs and white but patchy in 8 limbs. White and brown focal structureless areas were seen in 20 and 18 limbs, respectively. Blue-grey linear cords were seen in 34 and blue-grey clods in 6 limbs.

Conclusion: CVI causes changes in vessel morphology, pigmentary, and scaling patterns in the skin which are picked up by dermoscopy. Further longitudinal studies could provide insight into the temporal progression of CVI.

Keywords: Chronic venous insufficiency; Cutaneous changes; Dermoscopy.