Download - EWMA 2013 - Ep516 - Dermoscopy diagnostic method of microangiopathy in chronic venous ulceration
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Dermoscopy diagnostic method of microangiopathy in
chronic venous ulceration
Javorka Delic, Vesna Mikulic Angiology Department
City Institute of Dermatology Belgrade, Serbia
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Microangiopathy
Microangioathy in postthrombotic chronic venous ulceration (CVU).
Microangioathy is the consequence of venous hypertension,venous stasis, chronic inflammation,ulcerations and reparative processes.
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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.
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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
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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.
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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.
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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.
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Case report 1
Dermoscopy finding
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Case report 1
Dermoscopy finding
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Clinic image
Case report 1
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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
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Case report 2
Dermoscopy finding
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Dermoscopy finding
Case report 2
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Case report 2
Clinic image
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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
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Case report 3
Dermoscopy finding
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Case report 3
Dermoscopy finding
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Case report 3
Clinic image
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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.
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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.
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Dermoscopy - diagnostic method of microangiopathy in
chronic venous ulceration
Prim. Dr. Javorka Delic
[email protected] President of Serbian
Wound Healing Society