Venous eczema cured thank-you letter

This charming lady and her right leg venous eczema cured at The Whiteley Clinic. She decided to write a letter of thanks and gave it to Prof Whiteley today at her appointment. She gave permission for it to be used as a testimonial.

Letter of thanks to Professor Mark Whiteley from a patient treated for venous eczema CEAP C4 at The Whiteley Clinic

Last year, the patient came to The Whiteley Clinic in Bristol. She had varicose veins of the right leg with skin damage at the ankle. This was diagnosed as venous eczema which is also medically called CEAP C4.

In the past, skin changes at the ankle have often been thought to be due to previous deep vein thrombosis (DVT). They have often thought of as “incurable”.

As such, many general practitioners, nurses and even surgeons still prescribe compression stockings or bandages for this condition.

However, research has shown that skin damage at the ankle is usually caused by varicose veins. In some cases, these are not even seen on the surface, the so-called “hidden varicose veins”. Medically, “hidden varicose veins” are called superficial venous reflux (SVR) or chronic venous incompetence (CVI).

It has now been agreed by the National Institute of Health and Clinical Excellence (NICE) that all patients with varicose veins and skin damage should be referred to a “vascular service ” (see: nice.org.uk/guidance/cg168/). The Whiteley Clinic fulfils all of the criteria of a NICE vascular service. Vein doctors doing their own scans do not fulfil these criteria.

Therefore all patients coming to The Whiteley Clinic with red or brown skin changes at the ankle, or eczema at the ankle, undergo venous duplex ultrasonography. This venous duplex ultrasound scan is performed by a Clinical Vascular Scientist (previously called Vascular Technologists) who spend most (if not all) of their working time scanning vein disease.

This specialised test shows which of the veins are involved and which of the techniques will successfully cure the problem. Moreover, by treating patients with skin damage (CEAP C4) this prevents progression to venous leg ulcers (CEAP C6).

Venous eczema cured by endovenous surgery.

This lady underwent endovenous laser ablation of the great saphenous vein, TRLOP closure of perforators and phlebectomies (stage I of The Whiteley Protocol). Subsequently, she came back for stage II of The Whiteley Protocol, ultrasound-guided foam sclerotherapy.

Approximately eight weeks after stage II, she came for her appointment and presented Prof Whiteley with this letter.

Her venous eczema has completely gone. Have varicose veins have gone. She now only has thread veins which are going to be treated by micro-sclerotherapy for a good cosmetic result.

She is thrilled that she has gone from being fearful of developing a venous leg ulcer now only having to worry about how her legs look!