Non-healing, Recurrent Venous Stasis Ulcer with Chronic Lipodermatosclerosis
Authors: Tae An Choi ANP-BC, Hiral Patel PA-BC, Nay Htyte MD FACC and Back Kim MD FACC.
Heart Vein NYC, New York, NY
(Figure 1, left) Venous stasis ulcers with a combination of hyperpigmentation, lipodermatosclerosis, eczematous dermatitis, subcutaneous edema and varicose veins. Shallow ulceration with a macerated border, an exudative reddened base, and surrounded by pigmented skin, suggesting that ulcers are venous in etiology. (Figure 2, right) The right picture was taken 7 days after the procedure demonstrating almost healed ulcers and hardly visible varicose veins.
This patient is in his mid-40s and has had chronic venous insufficiency since his late 30s. The fibrotic skin change with increased pigmentation involves most of the medial calf (figure 1). His ulcers develop and recur within lipodermatosclerosis (figure 1). Failure to heal and/or prevent ulcers correlates the severity of lipodermatosclerosis which is resulted from a complex inflammatory cascade due to untreated venous hypertension. Tortuous, subcutaneous varicose veins along the medial calf, which represents a tributary of an underlying incompetent great saphenous vein (figure 1).
This patient underwent the endovenous laser ablation. The post-op picture was taken 7 days after the procedure demonstrating almost healed ulcers and hardly visible varicose veins (figure 2).
14 days post-op
21 days post-op