靜脈曲張引起的鬱血性濕疹

鬱血性濕疹(stasis eczema)，是因靜脈血液逆流引起靜脈高壓，導致下肢產生慢性發炎性的一種皮膚病，通常好發於年長者。

在臨床表現上，特徵為濕疹樣變化、紅斑性脫屑斑塊，並可能會因為滲出的紅血球釋出鐵離子、造成含鐵血黃素沉積，而在下肢出現皮膚色素沉澱。從病理機轉來看，這些紅血球外滲所釋放的鐵離子會引發一連串的發炎反應。若放任疾病不予治療，鬱血性皮膚炎將可能惡化並進展為嚴重的併發症，包括腿部腫脹、脂肪皮膚硬化症（Lipodermatosclerosis）甚至是靜脈潰瘍。

這位80歲的阿姨在來診後，超音波檢查確定同側腿部大隱靜脈有逆流情形，在接受血管內雷射閉合手術之後，濕疹發炎情形已大幅改善，原本的滲液情形已消失，也不怎麼會癢了！

治療前 - 濕疹呈急性發炎狀，偶有滲液及搔癢感

治療後一周 - 發炎狀況已大幅改善

治療後一個月 - 僅存曾經發炎過的色素沉澱痕跡

靜脈曲張在第四期會有各式各樣的變化，如濕疹、急性發炎、色素沉澱等，在這個階段治療皮膚仍有機會恢復正常，若色素沉著已定型或是演變成靜脈潰瘍，治療後的自我修復時間又會在更長，因此有症狀的靜脈曲張建議要盡早尋求專業醫師進行評估，尤其，超音波判定逆流時間是其中重要的一環！

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