[The current concept of the pathogenesis of trophic skin lesions in chronic venous insufficiency from the morphologic viewpoint].

Disturbances of the venous macrocirculation are the main cause of trophic skin lesions in primary and secondary chronic venous insufficiency. The microcirculatory process initiates with functional and organic endothelial alterations in the cutaneous and subcutaneous capillaries, followed by increased permeability for blood plasma and erythrocytes, and later by edema and micronecroses in the interstitial tissue. Subsequently a reactive chronic inflammation develops. A vicious circle consisting of repeated tissue necrosis alternating with repair processes and later with tissue fibrosis may develop. This injury and repair process is non-specific and characteristic for all types of tissue necrosis. Intensity and duration of the process depend on degree and persistence of the underlying disorder.