A.R. Shipman; G.W.M. Millington

Disclosures

The British Journal of Dermatology. 2011;165(4):743-750. 

In This Article

Obesity, Vascular Disorders and Ulceration

Excess body weight puts extra stresses on the vascular system.[75,76] There is an association with varicose veins, possibly in part due to valve failure due to the high intra-abdominal pressures.[75] Venous insufficiency then leads to varicose eczema and ulceration.[76] Obese persons may have a higher pain threshold than the nonobese.[77] This decreased pain sensitivity might partly be the reason for the development of distal venous and pressure ulcers in obese individuals.[78]

Occasionally, severe obesity is associated with the development of massive necrosis of both subcutaneous fat and the overlying skin.[79] This may lead to secondary infection and ulcer formation.[76,80] The lymphatics are a fragile network of vessels that cause huge morbidity if they fail, with gross oedema and increased risk of infection due to the collection of protein-rich fluid in the tissues.[80,81] Lymphoedema presents as a soft, pitting swelling most commonly over the shins. It is often associated with obesity,[7,22] particularly the massive localized form of lymphoedema.[82]

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