stasis subcutaneous sclerosis
Introduction
Introduction to stasis subcutaneous sclerosis Stasis subcutaneous sclerosis is a rare subcutaneous fibrous connective tissue hyperplasia caused by varicose veins in the lower extremities and stagnant blood circulation. It is a rare form of stasis eczema and stasis ulcer disease caused by varicose veins of the lower extremities. Because there are calf varicose veins in the calf before the onset of this disease, and there are incomplete varicose veins in the calf, and there are no obvious varicose veins, there are also deep and superficial venous traffic insufficiency, so the traffic valve dysfunction may be It is the starting factor of the onset. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: lower extremity venous thrombosis
Cause
Causes of stasis subcutaneous sclerosis
Traffic valvular insufficiency (75%):
Because there are calf varicose veins in the calf before the onset of this disease, and there are incomplete varicose veins in the calf, and there are no obvious varicose veins, there are also deep and superficial venous traffic insufficiency, so the traffic valve dysfunction may be It is the starting factor of the onset.
Pathogenesis:
Due to insufficiency of deep and superficial venous valvular valve dysfunction, obstructing blood flow from superficial vein to deep venous return, causing superficial varicose veins for a long time; long-term venous congestion may cause phlebitis, and then peri-vein inflammation; involving adjacent tissues and small blood vessels to produce microcirculatory disorders and When adipose tissue, it may cause degeneration and necrosis of fat cells, and release fatty acids to aggravate local inflammatory reaction; fat lobular septal connective tissue hyperplasia, which leads to stasis hardening, combined with the above-mentioned tissue lesions, thus forming irregular subcutaneous hard plaques, when lymph When the tube is compressed, it can cause leakage of lymphatic fluid; when the dermal papillary capillaries are involved, it causes progressive pigmentation, and it does not cause severe calf edema due to no deep vein involvement, due to the gradual establishment of collateral circulation and small angiogenesis. Maintain local blood circulation, so it does not cause local tissue dystrophies, skin eczema and necrotic ulcers.
The pathological changes were mainly due to the significant proliferation of fibrous connective tissue in the lower part of the dermis and the subcutaneous fat lobules, resulting in a widening of the interlobular septa; the number of fine blood vessels increased, the wall of the tube was thickened, the lumen was dilated, and the red blood cells were filled with no thrombus. A small amount of lymphocytes were scattered, and the epidermis and fat cells were normal. The modified van Gieson staining and MAB staining showed that the proliferation was collagen fibers, and the elastic fiber staining showed that the diseased blood vessels were veins.
Prevention
Stasis subcutaneous sclerosis prevention
1. Primary prevention: For factories that are engaged in long-term standing work, enterprises should be protected by labor. For example, they should apply elastic stockings or elastic bandages during work, and organize work spaces during work.
2. Secondary prevention: Patients with mild varicose veins use elastic bandages or elastic stockings to raise the affected limb.
3. Active treatment of the primary disease.
Complication
Stasis subcutaneous sclerosis complications Complications of lower extremity venous thrombosis
A small number of progressive pigmentation-like manifestations and stab plaques occur after lymphatic leakage.
Symptom
Symptoms of stasis subcutaneous sclerosis common symptoms nodular varicose edema
The damage originated in the lower third of the calf in the calf, and the left side is more than the right side. The lesion occurs in a subcutaneous adipose tissue in a subtle manner. It is a hard induration of 1 to 3 soybeans to broad beans, and gradually integrates into each other. Plaque, clear edges, light red skin or skin tone, mild pain and tenderness, and then slowly develop upwards, that is, new small nodules appear on the edge of the original large plaque, gradually increasing its area, fixing In the subcutaneous tissue, the vein is expanded or cystic, and the bump is uneven, hard and soft, the largest plaque can reach 15×10cm, the lower edge can reach the inner iliac crest, and the upper edge can reach the lower leg. 2/3, does not involve the outside of the calf, standing or walking for a long time, the local edema is aggravated, the plaque is tight, the edge is more red and swollen, the local pain and tenderness are more obvious, but no symptoms such as fever and lymphadenopathy, rest After the edema is relieved, and the plaque does not disappear obviously. After treatment, most or almost all of the plaque subsides, the subcutaneous fat tissue shrinks to varying degrees, the epidermis becomes thinner, smooth and shiny, the pigment is deepened or a little desquamation, and the damage is long-lasting. There are different ways Degree pigmentation; there are 1 or 2 nodular erythematous lesions unrelated to hard plaques, all of which have mild to moderate saphenous veins and their branch varices, even on both sides There are varicose veins, but only one of the calves has a hard subcutaneous plaque, and the subcutaneous tissue lesions have occurred in the calf with varicose veins. The varicose veins occur 1 to 30 years before the subcutaneous tissue lesions.
Examine
Examination of stasis subcutaneous sclerosis
Laboratory tests for stasis subcutaneous sclerosis include: routine urine tests, blood tests, anti-streptolysin "O" test, erythrocyte sedimentation rate (ESR) measurement, serum mucin (SM) measurement, traffic venous valve Functional tests, angiographic examinations, and B-ultrasound examination of the blood vessels in the legs. Diagnose the disease with all the laboratory tests involved.
Diagnosis
Diagnosis and identification of stasis subcutaneous sclerosis
The disease should be differentiated from varicose veins of the lower extremities. Varicose veins of the lower extremities are a common disease, especially in people who are engaged in long-term manual labor or standing work. Mainly manifested as superficial vein expansion of the lower extremities, elongation, distortion, resulting in soreness, fatigue, heavy and other symptoms of the affected limbs, severe cases often accompanied by complications such as calf ulcer or superficial phlebitis. Feasible B-ultrasound checks are made clear.
