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Skin Changes & Ulcers

Vein failure leads to abnormally high pressure in the leg veins which can force fluid out into the tissues causing swelling (edema). High vein pressures and stress on the vein walls also leads to red and white blood cells being forced or migrating out of the blood vessels into the tissues. When this occurs over an extended period of time, venous insufficiency can cause a number of skin problems.

As red blood cells break down their iron is deposited in the tissues leading to a brown discoloration (skin pigmentation). As activated white blood cells enter the tissues they release chemicals that damage the tissues. This may lead to the build up of products (e.g. fibrin) that impede diffusion of oxygen and other nutrients. The first skin signs are often mild eczema with wet and itchy, red scaly skin (varicose eczema), usually just above the ankle. More advanced skin lesions appear as shiny white areas of skin (atrophie blanche) or include hardening of the fatty layer beneath it (lipodermatosclerosis).

The ultimate result can be death of the tissues surrounding the veins leading to ulceration (venous stasis ulcers). The typical venous ulcer occurs on the lower leg (usually near the ankle where the vein pressures are highest) and is often surrounded by skin having a rusty brown color.