Focus on corona phlebectatica: Diagnostic, significance and predictive value in chronic venous disorders

Background

Corona phlebectatica (corona) is a clinical sign associated with chronic venous disorders (CVD). It is a good predictor for skin changes indicating a decompensation of the disease. However, it is not yet included in the clinical part of the CEAP classification, mainly due to the lack of operational criteria for its positive diagnosis.

Aim

To focus on the diagnostic and predictive values of corona, and to answer some relevant questions: How to define relevant operational criteria for a simple and reliable diagnosis in daily practice? Is the diagnosis reproducible? What is the value of this sign for the prognosis of CVD and their treatment?

Results

In order to clinically define corona, the association of blue telangiectases and stasis spots has the best specificity, and the blue telangiectases is the most sensible item. Their associated presence can be considered as a good operational criterion for the positive diagnosis of corona.

Corona has also shown to be significantly correlated with the presence of incompetent leg perforator veins.

The presence of corona also has a high value to predict the occurrence of skin changes and venous ulceration in the next few years of evolution of the disease.

Conclusion

Corona should no longer be considered as simple telangiectases of the foot (C1). It is a simple and reliable clinical entity, extremely relevant for the severity of the disease.

This is the reason why a careful examination of the ankle should be done in any patient with CVD.