VENOUS ULCERS, VENOUS ECZEMA, VENOUS SKIN CHANGES.

When the venous system in the leg fails to work normally the pressure in the leg veins rises. This reduces the circulation in the lower leg particularly around the ankle leading to swelling, discomfort, skin changes and eventually ulceration. Varicose veins, a previous DVT, or primary failure of the valves in the veins can all contribute to this.

ECZEMA AND SKIN CHANGES.

A form of eczema can occur in the calf, sometimes over an area of varicosity. The skin is red and itchy. Areas of the calf and around the ankle may develop a brown stain in the skin. The ankle area may be prone to swelling towards the end of the day. Sometimes the entire lower leg feels tight and hard, and may look red and inflamed. This may be acute lipodermatosclerosis (LDS) due to the high venous pressure or an infection (cellulitis).

ULCERS

There are many theories to explain why the raised pressure in abnormal leg veins leads to skin problems. There is some evidence to support all these theories and they probably all play a role to some extent. The skin becomes vulnerable, and is poor at healing. A small injury, insect bite, or minor infection which would normally heal, instead progresses, and an area of skin breakdown results. This does not heal and is called an ulcer. In the presence of venous disease, the term Venous Ulcer is used. There are many other factors that prevent ulcers from healing such as infection, poor blood supply via the arteries and reduced sensation via damaged nerves. These may all interact with venous disease producing a complex problem. Achieving healing in a difficult ulcer can be a major challenge and may require a team of specialists.