Which physical findings are characteristic of varicose veins and spider veins (telangiectasia)?

Updated: Feb 28, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Answer

Inspection may reveal such findings as ulceration, telangiectasias, atrophie blanche, interdigital mycosis, acrocyanosis, eczematous lesions, microulcers, stasis dermatitis, flat angiomata, prominent varicose veins, scars from a prior surgical operation, or evidence of previous sclerosant injections. Measuring and photographing lesions is recommended because patients undergoing treatment for varicose and spider veins often forget the original appearance of their legs and feet and may report that preexisting lesions were caused by treatment.

Normal veins typically are visibly distended at the foot and ankle and occasionally in the popliteal fossa. For other regions of the leg, visible distension of superficial veins usually implies disease. Translucent skin may allow normal veins to be visible as bluish subdermal reticular pattern, but dilated veins above the ankle usually are evidence of venous pathology.

Discolored skin often is a sign of chronic venous stasis, particularly if it is localized along the medial ankle and the medial aspect of the lower leg. Nonhealing ulcers in this area are most likely due to underlying venous stasis. Skin changes or ulcerations that are localized only to the lateral aspect of the ankle are more likely to be related to prior trauma or to arterial insufficiency than to pure venous insufficiency.


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