[Epidemiology and pathogenesis of varicosities]

Epidemiologic studies have shown that over 70% of the population in the Federal Republic of Germany have pathologic changes in the peripheral venous system, from which 5% require treatment. In the Basler Study, varicose veins were found in 26% of those 25 to 36 years of age and in 74% of those 65 to 74 years old. In earlier years, according to a questionnaire of the US National Health Survey there was a prevalence of varicose veins of 0.8% in men and 3.5% in women. In a similar study in the United Kingdom, the prevalence was 2.25%, in Denmark 2%. In contrast, in men of the Maori tribe, 36.3% had varicose veins while the women were affected in 47.4% as compared to 21.5% in the white male population and 40.4% in white women. According to the World Health Organization, varicosities are defined as saccular or cylindrical widened superficial veins where the widening may be circumscribed or segmental. In general, the dilatation of the veins is associated with tortuosities. There are various causes of primary varicose veins whereas secondary varicosities are usually due to a postthrombotic condition (Figure 1, Table 1). Primary varicose veins predominantly manifest themselves in the domain of the great saphenous vein and infrequently in the region of the lesser saphenous vein (Figure 2). Lateral branch varicosities are generally an isolated condition. Microvaricosities may appear as a network or arcade-like pattern of intradermal vessels (Figure 3) or reticular with a diffuse, small caliber network in the upper layers of the subcutis (Figure 4). Varicosities of the perforating veins occur subsequent to local incompetence.(ABSTRACT TRUNCATED AT 250 WORDS)