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| Fig. 59.5 Chronic venous insufficiency manifesting as marked erythema and edema, often called stasis dermatitis. |
Chronic venous insufficiency is due to venous hypertension secondary to valvular incompetence in the superficial, perforator, or deep veins, with many patients having defects in two or more valve systems. The most severe disease is produced by deep valvular insufficiency. Valvular insufficiency may be the consequence of hereditary factors (absent or congenitally incompetent valves), prolonged standing, and venous thrombosis that may damage valves. Chronic venous hypertension, depending on the degree of severity, may manifest as edema, varicosities, brown pigmentation secondary to hemosiderin, superficial neovascularization, dermatitis, and venous ulcers (Fig. 59-5). Studies have also shown that obesity is a separate risk factor for the development of chronic venous insufficiency.
