Stage classification of chronic venous insufficiency (CVI) according to Widmer.
| Widmer stage |
Description |
| I |
- Swelling of the legs in the evening, reversible edema (water retention)/ankle edema overnight.
- Local vasodilatation (spider veins) in the ankle region and above the arch of the foot.
- Corona phlebectatica – appearance of dark blue skin veins at the edge of the foot (= perimalleolar vein drawing).
|
| II |
Persistent swelling of the legs (= lower leg edema) with changes in the skin such as:
- Atrophy blanche (capillaritis alba) – small white areas of mostly coarse, scarred consistency, which occur preferentially in the area of the lower leg or upper ankle joint.
- Hyperpigmentation (increased pigmentation) of the skin
- Lipodermatosclerosis (dermatoliposclerosis) – increase in connective tissue and reduction of the subcutaneous fat layer, especially in the area of the ankle.
- Purpura jaune d’ocre – orange-brown pigmentation in the ankle / lower leg area caused by hemosiderin deposition.
- Stasis dermatitis – chronic form of eczema, usually localized on both sides of the distal lower legs (= eczematization: frequently itchy stasis eczema).
- Cyanotic skin – purple to bluish discoloration of the skin.
|
| III |
- Ulcus cruris venosum (venous leg ulcer (“open leg”) that has occurred as a result of advanced venous disease) or scar as a secondary condition
|
