Changes in Microcirculation in Patients with Atrophie Blanche Visualized by Laser Doppler Perfusion Imaging and Transcutaneous Oxygen Measurements

Abstract

Objective: To quantify differences in microcirculation in atrophie blanche (AB) in patients with chronic venous insufficiency (CVI) and in healthy controls before and after venous occlusion. Design: Prospective study in a single patient group. Setting: Department of Dermatology, University Hospital Maastricht, The Netherlands. Patients and methods: Sixteen patients with CVI and large lesions of AB, 10 patients with CVI without AB and 10 healthy controls were enrolled in the study. Laser Doppler perfusion imaging (LDPI) measurements were performed in and outside large lesions of AB and in healthy controls. Transcutaneous oxygen (Tc Po2) measurements were performed in patients with CVI with and without AB and in healthy controls. Results: Median basal resting flow was higher in AB than in healthy controls (0.67 mV versus 0.21 mV, p = 0.002). The venoarteriolar response (VAR was increased significantly in AB (58% versus 43%, p = 0.04). A significant decrease in Tc Po2 values occurred in AB lesions with 40 mmHg, in CVI skin with 60 mmHg and in healthy controls with 80 mmHg. Conclusion: Basic resting flux in AB measured with LDPI is increased compared with clinically normal skin. The decrease in flux on venous occlusion is larger in AB than in healthy controls.