Fluorescence microlymphography in chronic venous incompetence.

In severe chronic venous incompetence there is not only microangiography of the blood capillaries, but the superficial lymphatic skin capillaries at the medial ankle region are damaged also. The network visualized after subepidermal injection of FITC-dextran 150,000 is interrupted by obliterations or is even completely destroyed. In addition, lymphatic microangiopathy may be diagnosed by increased leakage of the dye out of the capillaries (enhanced permeability) and by phenomena of cutaneous reflux (parts of the network filling from deeper invisible channels). It is concluded that formation of indurated edema in chronic venous insufficiency arises at least in part from lymphatic microangiopathy.