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Lower extremity telangiectasias, reticular and varicose veins develop as a result of venous system impairment.
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Incidence: very common and the incidence increases with age. Reticular veins can occur in up to 10% of children 10 to 12 years old. The incidence of varicose veins in the seventh decade is 72% in women and 43% in men
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Age: more common in adults and elderly
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Sex: more common in women
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Precipitating factors: familial predisposition, pregnancy, static gravitational pressures, dynamic muscular forces, hormonal influences
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Venous pathology develops when venous return is impaired for any reason.
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It can develop from venous obstruction (thrombotic or nonthrombotic) or from venous valvular incompetence.
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Lower extremity telangiectasias are red to violaceous in color and up to 2 mm in diameter. Reticular veins are blue to blue-green in color and up to 4 mm in diameter. Varicose veins are blue to blue-green in color with a diameter greater than 3 to 4 mm.
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Dilated vascular channels in the dermis.
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Doppler ultrasound and/or duplex scanning are indicated in the following clinical scenarios:
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Asymptomatic varicosity greater than 4 mm in diameter
Symptomatic veins
Reticular, perforating, and/or varicose veins
Signs of venous insufficiency or stasis changes
Prior history of deep vein thrombosis or thrombophlebitis
Prior history of sclerotherapy with recurrences or bad outcome
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Sclerotherapy is the treatment of choice for lower leg telangiectasias and reticular veins. It should be repeated at 6 to 8 week intervals. Patients may require two to six sclerotherapy sessions to achieve the greatest treatment benefit.
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An ideal sclerosing agent causes complete local endothelial destruction of the vessel wall with secondary fibrosis and lumen obliteration, ...