​Dermatology - Thrombophlebitis

​Dermatology - Thrombophlebitis
Superficial phlebitis refers to the inflammation and blood clot formation in a superficial vein, typically caused by infection or damage resulting from the use of needles and catheters. Inflammatory thrombosis in varicose veins typically occurs in the setting of chronic venous insufficiency syndrome.

Patients report experiencing pain or discomfort in the affected limb or observe swelling in the limb. Certain individuals may exhibit asymptomatic conditions. Pitting edema may manifest, although it is not universally observed, and a sensitive cord may be palpated at the site of venous thrombosis. In cases of iliofemoral thrombophlebitis, there is swelling in the limb extending from the foot to the inguinal region. Although there is no discomfort in the limb, collateral veins may develop from the thigh to the abdominal wall. The affected limb may exhibit a significant lack of color and experience intense pain (known as phlegmasia alba dolens), or it may seem bluish and unpleasant with cold fingers or toes if the blood flow from the arteries is also impaired (known as phlegmasia coerulea dolens). Calf vein thrombosis manifests as swelling and increased temperature in the calf and foot, accompanied with profound discomfort in the calf region, often without the presence of a detectable chord. Migratory phlebitis refers to an inflammation and hardening of superficial veins that moves within a specific area of the body. It can be linked to thromboangitis obliterans and malignancies. Sclerosing phlebitis refers to the hardening and inflammation of a vein located beneath the skin, extending from the breast to the axillary region. As the vein heals, it becomes shorter and causes the skin to wrinkle.

The diagnosis of superficial thrombophlebitis is made based on the presence of distinct hardening of a superficial vein accompanied by redness, sensitivity, and heightened temperature. Doppler ultrasonography imaging shows a lack of blood flow or the absence of the typical changes in venous flow caused by respiration in cases of proximal venous blockages. The differential diagnosis comprises lymphedema, cellulitis, erysipelas, superficial phlebitis, lymphangitis, and, rarely, rupture of the plantar muscle.
The recommended treatment consists of applying compression, administering antiplatelet medications, and using nonsteroidal anti-inflammatory drugs.