Dermoscopy diagnostic method of microangiopathy in

chronic venous ulceration

Javorka Delic, Vesna Mikulic Angiology Department

City Institute of Dermatology Belgrade, Serbia

Microangiopathy

Microangioathy in postthrombotic chronic venous ulceration (CVU).

Microangioathy is the consequence of venous hypertension,venous stasis, chronic inflammation,ulcerations and reparative processes.

The aim of this study

Objective: The presentation of the blood wessels and pigmentation of the papilar dermis by dermoscopy HEINE, Delta 20. 57 patients, with CVUs, which were confirmed by clinical and Color Duplex Exams. The group consists of 32 female, 25 male with fotodocumentation–clinic image, dermoscopy.

Results

Venous capillares in papilar dermis:

dilated, derformed, like lacuna, individual or

grouped in globula formation and often, in

formation like pomegranate (more globula)

which are localised near of the ulcerations.

On places of atophy or sclerosys there werent

visible blood wessels and the pigment

deposits

Results

Pseudo–network Localised near of ulceration,(hemosiderin,melanine) present the residual pigmentation in stasis dermatitis. Also, pseudo-network is a sign of the phenomena of lowering melanine in deeper leyer beacouse of the disturbance of basal membrane and epidermal barrier.

Results

Pappering Maccular pigmentation is a very tipical finding the sign of the increasing acitivities of the macrophags usually increasing in lymphoedema, inflammation, infection.

Pappering was the most enlarges on zones near the cicatrix.

Case report 1

Men,62 years. Posttrombotic synd. sin. Color Duplex: Insuff.VSM, VV perf. V.Poplitea,VV tib.post.Repetative ulcerations.

Dermoscopy: Pseudo-network on the limb left (residual pigmentation,brown color), defect of the tissue dilated bood wessels in papilar dermis, in formation globula.

Case report 1

Dermoscopy finding

Case report 1

Dermoscopy finding

Clinic image

Case report 1

Women 60 years. Synd postthromboticum

cr dex.Repetative ulecrations . Color

Duplex: Insuff VSM dex,VV perf dex,

med, inf., Insuff VV tib post.VV Peronealis.

Dermoscopy: Pseudo-network ,brown color

near of the blood wessels. White areae

(cicatrix). Blood wessels as lacuna like and

Pomegranate (more globuls) .

Case report 2

Case report 2

Dermoscopy finding

Dermoscopy finding

Case report 2

Case report 2

Clinic image

Women, 32 years. Posttrombotic syndrome cr sin. Color Duplex: Insuffitientia VSM and VV reforantes cr in med. V.poplitea sin. Repetative ulcerations.

Dermoscopy: Dillated wessels in globula formation, near the healed wound; residual pigmentation in papilar dermis( dark color), macular white fibrin tissue (atrophy of the skin);

Case report 3

Case report 3

Dermoscopy finding

Case report 3

Dermoscopy finding

Case report 3

Clinic image

Diagnostic method

Dermoscopy as a diagnostic method of the

microangiopathy, is representing different

residual pigment deposits in papilar

Dermis disturbance of blood wessels as

lakuna, globulas, pomegranate atrophy and

sclerosis of the skin.

CONCLUSION

The type of skin has influence on the resultats (Fitz–Patrick) sex (estrogen depended pigmentation) but the most importante influence have the stadium of disease (C5 and C6). Dermoscopy is adjuvante and very confortable, not expansive method. For examination of micocircultion state in chronic venous insuffitienty. Key words: Dermoscopy, chronic ulceration, pigmentation, blood wessels.

Dermoscopy - diagnostic method of microangiopathy in

chronic venous ulceration

Prim. Dr. Javorka Delic

drdelic@orion.rs President of Serbian

Wound Healing Society