In daily life, you can often hear someone say “I have vasculitis of the lower extremities” the phrase. But the performance of each person is not the same, someone’s calves “veins” protrude, shaped like earthworms coiled; someone’s feet dry, purple, black, like old branches; someone’s calves thick, swollen, as if “elephant legs”. The people call these “vasculitis”, but from the medical point of view, their causes are different, treatment methods are not the same, we will count the following to distinguish between these three “vasculitis”. Shanghai Changhai Hospital Vascular Surgery Department Tian Wen Venous “vasculitis” Many people call varicose veins of the lower extremities “vasculitis”, which is a disease caused by venous insufficiency of the lower extremities. Patients often complain of “veins” protruding from their lower legs, easy soreness and fatigue when walking, and swollen legs. As the disease progresses, black half-dots gradually appear on the calves and ankles, fusing into patches, accompanied by “oily” skin and hair loss. At a later stage, if a bruise occurs on the foot, the wound will not heal easily and the wound will gradually enlarge. These symptoms can appear from a young age, and if not protected, they usually develop in 10-20 years, causing a lot of inconvenience and pain to the patient. How to prevent and treat? Physical therapy is the most important tool for venous disease of the lower extremities. Reducing prolonged standing and walking, elevating the lower extremity for about 5 minutes in 1-2 hours to promote venous return, and using medical compression stockings to support the veins of the lower extremity can help slow down the development of the disease. If the disease is more serious and affects your life, you will need to go to the hospital for surgery. Arterial “vasculitis” There are also two types of arterial “vasculitis”, usually caused by lower extremity arterial sclerosis and occlusion in the elderly, and usually caused by lower extremity arterial inflammation in the young. Although the causes are different, both cause a reduction in blood supply to the lower extremities due to narrowing and occlusion of the arteries, resulting in symptoms. This type of “vasculitis” begins with a “chill” in the foot, and gradually develops into a sore, painful lower extremity after walking a certain distance, requiring a few minutes of rest before continuing to walk, and the walking distance becomes shorter and shorter, and gradually the pain in the lower extremity at rest appears. Finally, there is ischemia, blackening and necrosis of the toes. For this type of “vasculitis”, the most important measure is to quit smoking. Atherosclerotic disease of the lower extremities is a systemic disease, and some common measures to prevent atherosclerosis, such as dietary control, more exercise, and active treatment of underlying diseases such as hypertension, hyperlipidemia, and diabetes, are basic measures. It is necessary to actively go to the hospital for treatment, regular checkups, and pay attention to controlling the development of the disease. Once the disease has progressed to an irreversible stage such as necrosis, amputation will be required. Lymphatic “vasculitis” Lymphatic “vasculitis” is currently relatively rare. The vascular system of the human lower extremity is divided into arteries, veins and lymphatic vessels. The role of the arteries is to supply blood to the limb, the role of the veins is to allow blood to return to the heart, and the role of the lymphatic vessels is to collect tissue fluid to return. Once the lymphatic vessels are blocked and speak, it will cause swelling of the lower limbs, and the long-term development will cause the skin to thicken and become rough and tough like “elephant skin”, which can be called “elephant skin swelling”, and once the skin breaks down, the wound will not heal for a long time. This type of “vasculitis” needs to be treated in a hospital to find the cause of the blockage. At the same time, effective physiotherapy is used to protect it in the same way as venous “vasculitis”. Another type of acute lymphatic “vasculitis” is an infection of the lymphatic system, called “Dantoxicosis”, “flowing fire”, which manifests as redness, swelling, heat and pain in the lower extremities from the feet to the lower legs, often accompanied by generalized The symptoms include redness, swelling, heat, and pain in the lower extremities and lower legs, often accompanied by a generalized fever, and require high-dose penicillin treatment. These patients usually have tinea pedis, which can be effectively prevented by paying attention to its control in general.