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Venous ulcer: epidemiology, physiopathology, diagnosis and treatment

Authors

  • Luciana P. Fernandes Abbade MD,

    Corresponding author
    1. From the Department of Dermatology and Section of Vascular Surgery of the Department of Surgery and Orthopedics, Clinical Hospital of the Medical School of Botucatu, Unesp, São Paulo, Brazil
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  • Sidnei Lastória MD

    1. From the Department of Dermatology and Section of Vascular Surgery of the Department of Surgery and Orthopedics, Clinical Hospital of the Medical School of Botucatu, Unesp, São Paulo, Brazil
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Luciana P. Fernandes Abbade, MD Department of Dermatology Clinical Hospital of the Medical School of Botucatu Unesp Rubião Junior Botucatu-SP CEP 18618-000 Brazil E-mail: lfabbade@fmb.unesp.br

Abstract

This review discusses the epidemiology, pathogenesis, diagnosis and current therapeutic options for venous ulcer. Venous ulcer is a severe clinical manifestation of chronic venous insufficiency (CVI). It is responsible for about 70% of chronic ulcers of the lower limbs. The high prevalence of venous ulcer has a significant socioeconomic impact in terms of medical care, days off work and reduced quality of life. Long-term therapeutics are needed to heal venous ulcers and recurrence is quite common, ranging from 54 to 78%. Thrombophlebitis and trauma with long-term immobilization predisposing to deep venous thrombosis are important risk factors for CVI and venous ulcer. The most recent theories about pathogenesis of venous ulcer have associated it with microcirculatory abnormalities and generation of an inflammatory response. Management of venous leg ulcers is based on understanding the pathogenesis. In recent years novel therapeutic approaches for venous ulcers have offered valuable tools for the management of patients with this disorder.

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