Abstract
Background
Chronic venous disease (CVD) is secondary to venous hypertension, leading to vascular inflammation and tissue changes. The impact of CVD on skin structure and barrier function is not well characterized.
Objective
We aimed to assess the characteristics of skin alterations in mild-to-moderate CVD by non-invasive techniques based on a prospective exploratory study.
Material & Methods
Female subjects (30–75 years) with CVD (Stage C2 to C4, CEAP classification) were eligible. Stage C0–C1 CVD subjects were used as controls. Women with leg surgery or a medical history that could impact the results were excluded. The skin changes on lesional (LS) and non-lesional (NLS) areas were assessed by biometric analysis including skin echography, viscoelasticity evaluation, confocal microscopy and trans epidermal water loss (TEWL) measurements.
Results
Thirty-four subjects were enrolled. Based on computation of 26 biometric parameters using Principal Component Analysis, a significant difference between LS and NLS zones, regardless of the CEAP class, was evidenced. C2–C4 subjects presented with dermal thickening suggesting oedema associated with decreased cell density, while no difference in skin viscoelasticity was observed compared to the C0–C1 control group. Epidermal structural modifications were associated with increased TEWL correlating with CVD severity.
Conclusion
Skin alterations in CVD patients are detectable by non-invasive methods. These findings may help to better assess new therapeutic strategies.
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Acknowledgments: we thank Dermatec for expertise in skin procedures and study conduct, Jean-Christophe Pittet (ORION Concept) for his help on in vivo confocal microscopy and echographic analysis, Cécile Bultez (CPP Initiatives) for medical writing assistance, and the CIRI team for their scientific support. Financial Support: this work was supported by SIGVARIS SAS. Conflicts of interest: AP, AM, CB, KS, JFN, MV, TL and AN have no conflicts of interest to disclose. CC is employed by SIGVARIS SAS. AL (DERMATEC) received a grant for the study.
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Paul, A., Braun, C., Mosnier, A. et al. Detection of skin alterations in mild-to-moderate chronic venous disease using non-invasive techniques. Eur J Dermatol 30, 505–515 (2020). https://doi.org/10.1684/ejd.2020.3873
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DOI: https://doi.org/10.1684/ejd.2020.3873