Treat Venous Disease Before Permanent Skin Discoloration Occurs
Some patients have long-standing untreated venous disease that ends up causing severe and permanent skin changes that can be a precursor to a venous stasis ulcer. This patient is a 68-year-old woman who had varicose veins for many years, but she was not aware that treatment would prevent this condition at her ankle. You can see from the image that there is a distinct white discoloration on the surface of the ankle and calf (atrophie blanche), which is a loss of pigmentation and thinning of the skin. The blue and purple veins are a clear indication of internal venous insufficiency that causes blood to pool in the lower leg instead of normally flowing up the leg against gravity. This constant force of gravity, in the presence of damaged veins, leads to reflux and backflow of venous blood that extends to the calf and ankle. What you see here is a very advanced form of venous disease.
Ultimately, the ultrasound and evaluation confirmed suspected reflux in the saphenous vein. VNUS Closure and sclerotherapy were done to normalize her circulation and obliterate the surface purple veins. Her symptoms of tenderness and ankle pain resolved quickly, but unfortunately, the skin changes seen in the photo are permanent.
Early evaluation and intervention with the treatment of varicose veins will prevent permanent damage to the skin and avoid related complications.