VENOUS LEG ULCERS - AN ANALYSIS OF UNDERLYING VENOUS DISEASE

Patients with venous leg ulcers have a readily recognized clinical syn drome of shallow ulcers, oedema, leg pain, venous ankle blush, lipoder matosclerosis, varicose veins, hyperpigmentation, and atrophie blanche , and they are assumed to have venous abnormalities. We examined 43 pa tients with venous leg ulcers, and compared those with obvious venous abnormalities (defined as historical or clinical evidence of deep veno us thrombosis or varicose veins) with those with presumed venous abnor malities (defined as lacking any such evidence), to see if they presen ted with different clinical features. We found that both groups had si milar clinical features, with the exception that lipodermatosclerosis was present more frequently in those patients with obvious venous abno rmalities (94 vs. 36%, P < 0.001). Most patients with presumed venous abnormalities had musculoskeletal conditions which might cause calf pu mp dysfunction (91%). Using air plethysmography, we were unable to con firm that all patients with presumed venous abnormalities did have int rinsic venous abnormalities. We propose that ulcers occurring in this clinical syndrome be designated as calf pump dysfunction ulcers (CPD u lcers), rather than venous ulcers.