[Is the pigmentation a characteristic sign for chronic venous insufficiency?]

In epidemiological studies pigmentations were declared a decisive criterium of stadium II of chronic venous insufficiency. It is discussed in this work if it is possible as the pigmentation is sometimes absent in advanced stages of chronic venous insufficiency. On the other hand it has got to be considered that there are many other possibilities of pigment building on the legs without chronic venous insufficiency. Pigmentation may be of actinic, endocrine, atrophic or especially of inflammatory origin. These pigmentations cannot be differentiated from those caused by chronic venous insufficiency macroscopically, and therefore, in our opinion, the question if pigmentation is a specific sign for chronic venous insufficiency has to be negated. Further, it is examined if the histomorphology of the pigmentation caused by chronic venous insufficiency offers a different aspect from that caused by other diseases. Special attention is given to the pigments containing melanin and iron. Melanin, as an example, is increased in skin inflammation whether there is chronic venous insufficiency or independent of any edematous changes, In subfascial chronic venous insufficiency without any inflammatory component, only the pigment containing iron increased.