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Have Massive Purple Splotching On Calf And Around His Ankle. What Is The Cause And Treatment?

Posted on Fri, 2 Nov 2012

Question: Over 22 years following traumatic leg injury, my 48-year-old son has massive purple splotching on his outside calf and even darker purpling all around his ankle. The skin often breaks open. His leg and foot swell often. What is the cause and how can we cure/treat it?

Answered by Dr. Srujal Shah (22 hours later)

Hi XXXXXXX,
I am Dr Srujal Shah, Vascular and Endovascular surgeon.
According to your description your son seems to have varicose veins and its sequele.
When he had some trauma and surgery 22 years back, he might have developed XXXXXXX vein thrombosis( Clotting of blood in large veins of leg) or he could have developed thrombophlebitis of veins( clot with infection in some of the leg veins).
Any one of above mentioned conditions can damage the normal valves of veins and lead to varicose veins( dilated and tortuous veins )with excessive pressure within them leading to venous hypertension which causes the purplish red patches near ankle and occaisionally can lead to ulcer formation and bleeding from the ulcers.

Varicose veins have 6 stages of development and swelling, skin discolouration and ulcer as well as bleeding comes in to grade 3 to 6 respectively.

Now, best thing to manage the condition is to get venous doppler scan of the leg to confirm the clinical diagnosis.

second step is to use grade II compression stockings , if the doppler also proves to be damages valves and dilated veins.

If your son gets frequent problems and the condition is varicose veins and its advanced stage, i would suggest to contact your vascular surgeon and get treated for it. Modern treatment involves minimally invasive ' radiofrequency ablation" or Laser / Glue ablation for thigh veins and Foam sclerotherapy / Phlebectomies for the below knee veins.

The procedure may take 1 hour time and can be done under local anaesthesia on day care basis or as a office based procedure.He should use stockings even after the procedure till the ulcer heals.

I hope i have satisfied youe query and i would be happy to answer further doubts or even treat your son. Please contact your vascular specialist as soon as possible to prevent further damage to the leg.

Thanks and regards,
Dr Srujal shah
Consultant vascular surgeon and endovascular interventionist.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Srujal Shah (7 hours later)

Thank you, Dr. Shah. Your information is very helpful. I failed to mention that the skin on my son's leg is soft, thin, and the texture is like an orange peel's surface. When skin breaks, it breaks from the outside when the leg bumps something, rather than from sores inside the leg. There are no visible varicose (enlarged/bumpy) veins. Could there be varicose or damaged veins hidden inside the leg?

Answered by Dr. Srujal Shah (17 hours later)

Hi XXXXXXX,
Yes, it still can be varicose veins. There may not be visible veins outside if there is perforator incompetency(they are bridges between superficial and XXXXXXX veins with valves).
And yes, even varicose ulcers starts with some of trivial trauma or scratch or even with itching.
The second possibility is of Lymphatic edema( Lymph is a fluid in our body which gets filtered from microcirculation and re enters the veins and circulation). If there is blockade of lymphatic channels, there can be leg swelling, orange like skin surface and watery discharge from skin. That is called Lymphoedema.
So I will recommend you to consult your vascular specialist and get proper diagnosis as earlier diagnosis is the key to prevent complications and get best treatment.
Hope your doubts are clear now.
Thanks and regards,
Dr Srujal shah

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar