SIGNS & SYMPTOMS, INVESTIGATIONS & DIAGNOSIS, TREATMENT PLAN

SIGNS & SYMPTOMS 

• Primarily cosmetic concern
• Pain
• Discomfort
• Swelling
• Irritation/itching
• Skin changes: hyperpigmentation (brown/red haemosiderin deposits), venous eczema

(itchy/red/flaky), lipodermatosclerosis (painful hardened tight skin), atrophic blanche (starshaped ivory white atrophic stars)

INVESTIGATIONS & DIAGNOSIS 

• Clinical examination (Make sure to check pulses & and rule out any arterial insufficiency)
• ABPI measurement required before compression therapy

TREATMENT PLAN 

Conservative measures:

• Reassurance: unlikely to develop complications
• Weight loss if indicated
• Active leg raising/elevation
• Compression stockings (only if ABPI 0.8-1.3)

Referral:

• Vascular referral if unsure
• Venous ulcers are not healing (not healed within two weeks)
• symptomatic varicose veins
• lower limb skin changes (e.g., eczema and pigmentation)