The end stage of venous insufficiency is the development of leg ulcers. Unfortunately, sometimes these ulcers can develop spontaneously or after trauma and can take months to years to heal. After months or even years of suffering from leg ulcers, if the venous disease is not corrected, forty-five percent (45%) of patients will get the ulcers back just to relive the painful experience all over again.
This is a 34 year old white man who has suffered from recurrent venous ulcers for years. He has a partial thickness ulcer that is well demarcated. It is the darkening of his skin and the hint of redness at the border between his normal skin tone and his hyperpigmented (darkened) skin tone that make the appearance of his leg classic for venous insufficiency. All of his skin changes are from his venous stasis and varicose veins. Notice that he does not have any significant obvious varicose veins. Forty-percent of individuals with leg ulcers from venous stasis do not have obvious visible varicose veins.