A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing) of the skin (lower legs and feet).
- Edema (swelling) of the legs
- Corona phlebectatica – appearance of dark blue skin veins at the edge of the foot.
- Atrophie blanche – usually painful depigmentation of the skin in the area of the lower leg.
- Eczematization – often itchy stasis eczema.
- Reddish brown hyperpigmentation due to local hemosiderosis – increased iron deposition in the ankle/lower leg area.
- Hyperkeratosis – excessive horn formation of the skin.
- Lipodermatosclerosis – proliferation of connective tissue and reduction of the subcutaneous fat layer, especially in the area of the ankle.
- Cyanotic skin – purple to bluish discoloration of the skin.
- Ulcus cruris venosum (ulcus cruris (“open leg“), which occurred as a result of advanced venous disease) or scar as a secondary condition.
- Inspection (viewing) of the skin (lower legs and feet).
- Health check