[Tissue oxygenation and microcirculation in dermatoliposclerosis with different degrees of erythema at the margins of venous ulcers. A contribution to hypodermitis symptoms].
BACKGROUND
In patients with chronic venous insufficiency erythematous areas in indurated skin (hypodermitis) and non erythematous areas of lipodermatosclerosis were examined.


METHODS
In 13 patients with venous ulcers a total of 32 localizations in more or less erythematous and indurated ulcer edges were measured. The amount of erythema was taken as an indicator for the extent of hypodermitis. The parameters examined were erythema (a-value), skin temperature (t), laser Doppler flow (LDF), transcutaneous (tcpO2) and intracutaneous oxygen tension (icpO2). According to the amount of erythema the different localizations were separated into two groups: areas with a-values lower than 14,2 were classified as lipodermatosclerosis without or with little erythema, are-as with a-values higher than 14,2 were classified as areas of lipodermatosclerosis with extensive erythema. Identical measurements were also performed in healthy looking skin below the knee.


RESULTS
Skin temperature and LDF were higher in areas with much erythema compared to those with little or no erythema. TcpO2, measured with an electrode temperature of 44 degrees C, was lower in areas with inflammation; tcpO2-values at 37 degrees C and icpO2-values showed no differences in ulcer edges with different amounts of inflammation.


CONCLUSIONS
The results show differences of microcirculation between areas of lipodermatosclerosis with and without hypodermitis. These differences did not influence the actual tissue oxygenation in deeper parts in the dermis.
Schmeller
W
W
Klinik für Dermatologie und Venerologie, Medizinische Universität zu Lübeck.
Roszinski
S
S
Huesmann
M
M
D000368:Aged; D000369:Aged, 80 and over; D001785:Blood Gas Monitoring, Transcutaneous; D004890:Erythema / Q000503:physiopathology*; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D012016:Reference Values; D012594:Scleroderma, Localized / Q000503:physiopathology*; D012867:Skin / Q000098:blood supply*; D012881:Skin Temperature / Q000502:physiology; D014647:Varicose Ulcer / Q000503:physiopathology*; D014689:Venous Insufficiency / Q000503:physiopathology*
Gewebeoxygenierung und Mikrozirkulation bei Dermatoliposklerose mit unterschiedlich stark ausgeprägtem Erythem im Randbereich venöser Ulzera. Ein Beitrag zum Krankheitsbild der Hypodermitis.