title: [Ulcers in obesity-associated chronic venous insufficiency].
abstract: BACKGROUND
  Chronic venous insufficiency is a frequently occurring disease consisting of a characteristic symptom complex and ulcerations. Normally, varicose veins with reflux or obstruction can be found. However, these symptoms have also been described in obese people and are considered functional chronic venous insufficiency. The aim of this work was to present patients with ulceration in obesity-associated chronic venous insufficiency and to describe typical features of ulceration in obese people.
  
  
  METHODS
  Seven patients with ulcerations of the lower limbs in obesity-associated chronic venous insufficiency were examined. Duplex sonography was performed; reflux or stenosis as well as a peripheral arterial occlusive disease could be excluded.
  
  
  RESULTS
  In all, 7 patients presented with grade I-III obesity. The duplex sonographic examination showed no evidence of reflux or obstruction. However, multiple ulcers were found located on the proximal or ventrolateral lower limb. Most of them occurred posttraumatically or after insect bites with typical signs of chronic venous disease including hyperpigmentation and erythema.
  
  
  CONCLUSIONS
  The cause of obesity-associated chronic venous insufficiency has been associated with an increased intraabdominal pressure due to abdominal fat masses. It leads to venous hypertension. Therapy consists of consequent compression therapy combined with suitable wound care, weight reduction, and regular exercise.
authors.affiliation: Klinik für Dermatologie, Venerologie und Allergologie, Venenzentrum der Dermatologischen und Gefäßchirurgischen Kliniken, Ruhr Universität Bochum, Hiltroper Landwehr 11-13, 44805, Bochum, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Scholl
authors.affiliation: Klinik für Dermatologie, Venerologie und Allergologie, Venenzentrum der Dermatologischen und Gefäßchirurgischen Kliniken, Ruhr Universität Bochum, Hiltroper Landwehr 11-13, 44805, Bochum, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Dörler
authors.affiliation: Klinik für Dermatologie, Venerologie und Allergologie, Venenzentrum der Dermatologischen und Gefäßchirurgischen Kliniken, Ruhr Universität Bochum, Hiltroper Landwehr 11-13, 44805, Bochum, Deutschland. m.stuecker@klinikum-bochum.de.
authors.forename: M
authors.initials: M
authors.lastname: Stücker
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000628:therapy; D017156:Photoplethysmography; D018616:Ultrasonography, Doppler, Duplex; D014647:Varicose Ulcer / Q000175:diagnosis* / Q000628:therapy; D014689:Venous Insufficiency / Q000150:complications* / Q000628:therapy; D015431:Weight Loss
keywords: Compression therapy; Dependency syndrome; Intraabdominal pressure; Ulceration; Venous hypertension