CUTANEOUS MICROCIRCULATION IN SKIN-LESIONS ASSOCIATED WITH CHRONIC VENOUS INSUFFICIENCY

BACKGROUND. There are various types of skin lesions in chronic venous insufficiency. OBJECTIVE. To determine an association between differen t skin lesions and different changes in the cutaneous vascular bed. ME THODS. Twenty-eight patients with chronic venous insufficiency (CVI) w ithout and with various types of skin lesions (ie, hyperpigmentation, lipodermatosclerosis, white atrophy, and venous ulcer) and 12 healthy control subjects were examined by video-capillaroscopy, transcutaneous oxygen tension measurement, photoplethysmography, and Doppler ultraso nography to detect disturbances of cutaneous microcirculation and veno us macrocirculation. RESULTS. There were no significant differences be tween the different CVI groups with respect to their venous function d isorder. However, important variations were noted in the cutaneous mic rocirculation. In all the patient groups, ail increase in the mean hal o diameter could be demonstrated even in clinically healthy skin. In a ll types of skin lesions, the mean capillary diameter tons significant ly enlarged. Severe morphological capillary changes and a significant reduction of the mean transcutaneous oxygen tension values were found in conjunction with lipodermatosclerosis and white atrophy and in the areas surrounding venous ulcers. CONCLUSION. The results of this study point to the conclusion that, once they have become established, micr ovascular disturbances play an independent vole in the development of the skin lesions associated with CVI.