Initial clinical manifestations are of pruitic macular to slightly papular erythematic lesions, which have a diffuse eruption area. As the condition is chronic, what begins as mild pruitic erythema gradually increases in intensity until it becomes persistent. Vesicles are likely to appear and weep if they burst. This may be followed by scaling which is indicative of persistent inflammatory changes. For this reason the external manifestation of venous stasis eczema is an important diagnostic tool for clinicians, indicating that circulatory problems may exist.
Venous insufficiency is caused by any factor that inhibits regular venous return.
Physical factors which inhibit the movement of blood from the lower limbs back to the heart. Often described as the 'peripheral heart', the calf muscles surround the deep veins of the legs. These deep veins are the paired vena comitantes of the anterior and posterior tibial arteries. Vessel incompetence is another common cause of venous insufficiency. Deep vein thrombosis is often the cause, damaging valves which prevent the backward flow of blood.