Clinical presentations of lower limb varicose veins; single surgical unit experience

Background Varicose veins (VV) are a routinely encountered problem in surgical clinics. Their presentation varies from pure cosmetic, symptomatic to active ulceration. Improved socioeconomic status in modern society have resulted more patients with VV presenting with cosmetic concerns and mild symptoms. These patients were previously overlooked in busy peripheral surgical units. Method Patients presenting with VV, as first visits to a single surgical clinic at GHK from 1st October 2014 to 31st March 2014 were analyzed. Clinical presentations were staged according to CEAP classification. Results Seventy two patients (40 females: 32 males) and 124 limbs with VV were studied. Mean age of study population was 54 years (18-78). Mean duration of VV at presentation was 3.8 years (3 months -20years). Among all first clinic visits 72 (19.4%) were due to VV. Bilateral VV (52/72) were more common than unilateral VV (20/72). C1-C3 categories were seen in 65% (81/124) of limbs. C4, C5 and C6 presentations were seen in 19.4%, 5.6% and 9.7% limbs respectively. One patient in C6 category had biopsy proven squamous cell carcinoma. Mean duration of active ulceration was 4.8 years (3months - 20 years). In C1- C3 category 62.96% were females and mean age was 46 years, whilst among C5-C6 category, mean age was 58 years and 42.1% were females. Conclusions Majority of the study group presented with early varicose veins disease. Patients in C1-C3 category were predominantly females and of young age. Even in a peripheral setting there is increased awareness and early health seeking pattern for VV.