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Body dysmorphic syndrome and telangiectasias (spider veins) in the legs

  • 06

    By Katherine Kozlowski, Medical Author and Contributor to Vein News and www.VeinsVeinsVeins.com

    A recent study highlights the psychological aspects of having telangiectasias in the legs. 

    The study is entitled "Body Dysmorphic Disorder in Patients with Telangiectasias". 

    What is a telangiectasia? 
    According to hss.edu, t
    elangiectasias (commonly known as "spider veins") are dilated or broken blood vessels located near the surface of the skin.  They often appear as fine pink or red lines, which temporarily whiten when pressed. "Matted" telangiectasias are clusters of these small dilated blood vessels that form a pink or red patch on the skin. Individuals who are otherwise healthy can develop this condition, and it is sometimes associated with varicose veins.

    Javier A Bravo and colleagues state in their manuscript that of the spectrum of clinical manifestations of chronic venous disease, telangiectasias are a "minor problem".  

    They classify "major problems" in chronic venous disease as "venous ulcer formation, vein thrombosis and varicose vein hemorrhage".

    They further state that "there are patients that might insist on continuing treatment, focusing excessive attention on what they perceive to be persistent telangiectasias that, in their opinion, must be removed. In these cases, one might be facing a possible body dysmorphic disorder (BDD) diagnosis".

    The authors performed a multi-center study in 223 patients with telangiectasias, (CEAP Classification C1s) seeking treatment; They had these patients sign the Body Dysmorphic Disorder Questionnaire (BDDQ).

    The study questionnaire was evaluated in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for body dysmorphic disorder. 

    What are the results of this study? 

    1)  17% of patients with telangiectasias had criteria for BDD according to the DSM-V.

    Telangiectasias can be a stress trigger that changes the way patients perceive their own appearance.

    3)  BDD patients tend to focus their attention excessively upon these types of veins and demand unnecessary treatment for minimal telangiectasias in order to diminish their discomfort with their physical appearance.

    4) Upon evaluation, these patients with telangiectasias that have BDD should be referred to a psychiatrist.

    5)  Initiation of any treatment for telangiectasias in patients with BDD should be avoided before the patient sees a psychiatrist.

    Bravo JA, Cifuentes S, Ulloa JH, Kabnick L, Pedrazolli A, Simkin C, Javier Julian, Santiago F.   Body dysmorphic disorder in patients with telangiectasias. Int Angiol 2021;  40(1): 18-22.