Question
A policeman of 45 years presented with Lipodermatosclerosis over lower medial aspect of left leg, along with a healed venous ulcer. As per the CEAP (Clinical-etiology-anatomy-pathophysiology) classification his clinical classification will be:
The correct answer is
C5
CEAP Clinical Classification Explained
The CEAP classification system grades venous disease severity. The 'C' stands for the Clinical classification, focusing on observable signs and symptoms. Key categories relevant here are:
- C4: Skin changes due to chronic venous disease. This is subdivided:
- C4a: Includes pigmentation (discoloration).
- C4b: Includes eczema, lipodermatosclerosis, or atrophy blanche.
- C5: Skin changes (as in C4) plus a healed venous ulcer.
- C6: Skin changes (as in C4) plus an active venous ulcer.
Applying CEAP to the Patient's Case
The patient presents with specific findings:
- Lipodermatosclerosis: This is a specific skin change related to venous insufficiency, fitting into the C4b category.
- Healed Venous Ulcer: The presence of a past, now healed, ulcer is crucial.
Determining the Clinical Classification
Based on the CEAP criteria:
- The patient clearly has skin changes (Lipodermatosclerosis), placing them at least in C4b.
- The patient also has evidence of a healed venous ulcer.
- The CEAP classification that combines skin changes (like lipodermatosclerosis) with a healed ulcer is C5.
Therefore, the patient's clinical classification according to CEAP is C5.
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