Skin Blood Flow in Chronic Venous Insufficiency

Abstract

Objective: To evaluate the skin temperature, laser Doppler flux (LDF), concentration of moving blood cells (CMBC) and speed of blood cells (SBC) in the liposclerotic and clinically normal skin of patients with chronic venous insufficiency. Design: Parallel groups study comparing patients with chronic venous insufficiency with control subjects. Setting: Vascular laboratory, Middlesex Hospital, University College and Middlesex School of Medicine, London, UK. Participants: Twenty patients with lipodermatosclerosis and chronic venous insufficiency comprised the disease group, and 15 subjects without venous disease comprised the control group. Main outcome measures: The skin temperature, LDF, CMBC and SBC were assessed in the gaiter area and on the dorsum of the foot. Results: A higher LDF (median LDF and interquartile range (IQR) = 132 (66–289), p = 0.001 (Mann-Whitney) and skin temperature (Median temperature and IQR = 31.1 (29.6–32.4), p = 0.001) was found in the liposclerotic skin of patients with chronic venous insufficiency compared with normal controls (median LDF and IQR = 49 (32–58); median temperature and IQR = 28 (27–30.3)). Similarly the LDF on the dorsum of the foot (median LDF and IQR = 73 (59–127), p = 0.03) and skin temperature on the dorsum of the foot (median temperature and IQR = 31.1 (30.4–32.1), p = 0.002) was significantly higher in the patients with chronic venous insufficiency compared with normal controls (median LDF and IQR = 55 (36–66), median temperature and IQR = 29.5 (26.7–30.7)). Conclusions: This study demonstrates that there is increased skin blood flow in both liposclerotic skin and clinically normal skin in patients with chronic venous insufficiency.