A new or overlooked finding of varicose veins: Ecchymosis

Manifestations of varicose veins include aching, itching, restless leg, edema, muscle cramps, leg ulcers, tightness, and heaviness. In spite of a thorough clinical assessment and duplex scanning, many patients with varicose veins have leg symptoms that are medically unexplained.1 A 35-year-old female presented with a several week history of night-time muscle cramps and ecchymosis on both legs. She specifically noticed that the ecchymotic areas would appear the day after nocturnal muscle cramping. A detailed history failed to reveal systemic disease, recent infection or malignancy. She denied using anti-platelet or anticoagulant medications. Her physical examination was normal except for telangiectasias and varicose veins (Panel A-1) on both lower extremities with surrounding irregular ecchymotic patches in different stages of evolution with brownish, pink, or deep purple discoloration (Panels A-2, A-3, and A-4, respectively). Her biochemical and hematological laboratory analyses were normal. Venous duplex A new or overlooked finding of varicose veins: Ecchymosis