[Ulcers in obesity-associated chronic venous insufficiency]

Area of Science:

• Vascular Medicine
• Dermatology
• Obesity Medicine

Background:

• Chronic venous insufficiency (CVI) is common, often presenting with varicose veins, reflux, or obstruction.
• Obesity is increasingly recognized as a contributing factor to CVI, termed obesity-associated CVI.
• This study focuses on ulcerations in patients with obesity-associated CVI.

Observation:

• Seven patients with Grade I-III obesity and lower limb ulcerations were evaluated.
• Duplex sonography excluded venous reflux, obstruction, or peripheral arterial occlusive disease.
• Multiple ulcers were observed on the proximal or ventrolateral lower limb, often post-traumatic or post-insect bite.

Findings:

• Obesity-associated CVI can manifest with ulcerations without typical venous reflux or obstruction.
• Ulcers in obese patients showed characteristic signs of chronic venous disease, such as hyperpigmentation and erythema.
• Ulcer location and presentation may differ in obesity-associated CVI.

Implications:

• Increased intra-abdominal pressure from obesity-induced abdominal fat masses may cause venous hypertension.
• Effective management requires a multi-faceted approach including compression therapy, wound care, weight reduction, and exercise.
• Understanding these unique ulcer characteristics is crucial for accurate diagnosis and treatment in obese individuals.