Phlebitis migrans is a special form of thrombophlebitis. Thrombophlebitis is an acute thrombosis in the veins close to the skin that occurs together with an inflammation. On the other hand, thrombosis in the deep veins is called phlebothrombosis. Phlebitis migrans is a thrombophlebitis that occurs in different parts of the body.
What is migratory phlebitis?
There are numerous synonyms for the term phlebitis migrans, for example phlebitis saltans, thrombophlebitis migrans or thrombophlebitis saltans. It is characteristic of phlebitis migrans that the vein does not appear as a varicose vein. The disease occurs in a chronological sequence and occurs in different places. See electronicsencyclopedia for Slang Pfeiffer Syndrome.
Basically, it is a thrombophlebitis that changes its localization. The thrombophlebitis in this particular case has the characteristics of appearing superficial, migratory and, above all, unexpected. At the same time, it is sometimes regarded as an early symptom of a so-called visceral occult tumor.
For this reason, the disease is also known as facultative paraneoplastic syndrome. In phlebitis migrans, a ‘migratory’ inflammation of the veins, the inflammation starts in areas of the vein that are already diseased. Inflammation can spread in the direction of blood flow or in the opposite direction.
The disease always affects the superficial veins near the skin. The inflammation is localized on the wall of the vein. As a result, a blood clot or thrombus can form, but this does not happen in every case.
Causes
In principle, phlebitis migrans can be an indication of serious underlying diseases. For example, it can occur as part of a paraneoplastic syndrome, such as pancreatic carcinoma, bronchial carcinoma or leukemia. In addition, phlebitis migrans can occur as an accompanying symptom in connection with bacterial and viral infections.
In many cases, however, it is not possible to determine the exact cause of migratory phlebitis. Phlebitis migrans occurs most frequently in combination with thromboangiitis obliterans. Observations indicate that up to 62 percent of those affected also suffer from phlebitis migrans.
Sometimes phlebitis migrans also occurs with vasculitis, such as lupus erythematosus, Wegener’s granulomatosis or giant cell arteritis in the presence of polymyalgia rheumatica. The reason for its development is probably a thrombotic, allergic-hyperergic reaction of the vessels. Such reactions can be triggered, for example, by chronic, bacterial focal infections.
However, Behçet’s disease, carcinomas of the lungs, pancreas and prostate as well as leukemia and malignant lymphogranulomatosis can also be the trigger. Tumors are able to release cysteine proteinases. This sets in motion a mechanism that has not yet been fully researched, which increases the production of the substance thrombin.
Symptoms, Ailments & Signs
Phlebitis migrans causes various typical symptoms and complaints in those affected. In many cases, the affected areas are found on the outside of the legs. Much less common is phlebitis migrans on the trunk or arm. The disease is characterized by reddening of the skin that occupies a small area and is painful.
At the same time, small edemas also appear in some cases. This type of phlebitis usually heals unexpectedly, so that no technical treatment measures are usually required. In the majority of cases, men are affected by phlebitis migrans. The disease usually progresses in phases and extends to different sections of the veins.
This shows an acute and painful, cord-like and easily palpable thrombophlebitis. Symptoms usually subside after two to three weeks, with mild hyperpigmentation usually remaining. Giant cells and histiocytes get into the vein. Phlebitis migrans can also indicate the presence of other diseases.
The disease is often associated with malignant tumors, Bürger’s syndrome, various autoimmune diseases or tuberculosis. For this reason, a clarification of other underlying diseases is urgently required.
Diagnosis & course of disease
The diagnosis of phlebitis migrans must always be carried out by a specialist. First of all, he discusses the medical history (anamnesis) with the patient, whereby the exact symptoms are also clarified. Imaging procedures are used in most cases to confirm the suspicion of phlebitis migrans.
With their help, the vessels of the extremities are analyzed. In addition, a biopsy should be considered. As part of the differential diagnosis, for example, the presence of panniculitis must be examined.
Complications
The symptoms of phlebitis migrans can be very different, so that a general course of the disease cannot usually be predicted. However, in most cases the symptoms themselves occur on the legs, so that there is significant reddening of the skin in these regions of the body. The skin itself can also become tense and painful.
In most cases, the disease also leads to hyperpigmentation, which negatively affects the appearance of the affected person. If phlebitis migrans is caused by a tumor, those affected also suffer from permanent fatigue and exhaustion. Weight loss and severe pain can also occur. In many cases, however, phlebitis heals itself, so that no additional treatment is necessary.
However, further treatment depends on the underlying disease, if necessary. Drugs are usually used for this. Smokers should give up the habit, since a healthy lifestyle has a very positive effect on phlebitis migrans. No other complications arise. However, hyperpigmentation can remain even after successful treatment.
When should you go to the doctor?
As a rule, phlebitis migrans should always be examined by a doctor. Since the disease does not improve without treatment and the symptoms often worsen, early diagnosis is important. The doctor should be consulted for phlebitis migrans if the skin becomes red or there are severe spots. This redness does not go away on its own and appears for no particular reason. Pain does not always occur with phlebitis migrans, but it can significantly reduce the patient’s quality of life.
If these spots appear in different parts of the body, you should consult a doctor. Hyperpigmentation can also indicate phlebitis migrans and should be examined. Since those affected by phlebitis migrans also suffer from a significantly increased risk of skin cancer, regular examinations by a dermatologist are very useful. Phlebitis migrans is usually diagnosed and treated by a dermatologist. It cannot generally be predicted whether this will lead to a reduced life expectancy of the patient.
Treatment & Therapy
The treatment of phlebitis migrans is primarily based on the causes, which, however, cannot be clearly identified in every case. Smokers are encouraged to give up the addiction. In addition, the search for tumors is increased.
As an external method of therapy for phlebitis migrans, heparin ointments and compression bandages are often used. Antiphlogistics or corticosteroids are usually used as part of internal therapy. After the flare-ups have healed, hyperpigmentation usually remains.
Outlook & Forecast
The further course of phlebitis migrans cannot usually be predicted in general, as this depends very much on the severity of this disease. Therefore, as soon as the first signs and symptoms of the disease appear, a doctor should be consulted and treatment initiated so that complications or other symptoms do not arise as the disease progresses. As a rule, phlebitis migrans cannot heal on its own, so that the affected person is usually dependent on a visit to a doctor.
If there is no treatment, the symptoms can spread to other regions of the body and cause problems there as well. Smokers are particularly affected and should therefore give up smoking completely or reduce it. A healthy lifestyle with a healthy diet can also have a positive effect on the further course of phlebitis migrans.
The symptoms can also be alleviated by treatment with various ointments or creams. However, in this disease, the treatment of the underlying disease is very important and should therefore be in the foreground. The life expectancy of those affected may also be reduced.
Prevention
According to the current state of research, there are no concrete measures to prevent phlebitis migrans. A healthy lifestyle and particularly not smoking may reduce the likelihood of developing phlebitis migrans.
Aftercare
In most cases, those affected by phlebitis migrans have only a few or limited direct follow-up measures available. With this disease, early diagnosis and subsequent treatment is very important, as this is the only way to prevent further complications and symptoms. Phlebitis migrans cannot heal itself, so ideally those affected should consult a doctor as soon as the first symptoms and signs appear.
In order to positively influence recovery, smokers should give up this habit completely. In general, a healthy lifestyle with a balanced diet also has a positive effect on the further course of the disease. Regular checks and examinations by a doctor are also very important in order to identify further tumors at an early stage and then remove them.
It is also not uncommon for various medications to be taken to alleviate the symptoms. Those affected should always ensure regular intake and the correct dosage. In the event of side effects or if anything is unclear, consult a doctor first. Despite treatment, the life expectancy of those affected by phlebitis migrans is significantly reduced in many cases.
You can do that yourself
When migratory phlebitis occurs, the most important action to take is to go to the nearest hospital or call an ambulance. In any case, the thrombosis requires immediate treatment, because otherwise it can lead to further symptoms and complications, including the death of the patient.
After the initial treatment, the causes of the thrombophlebitis must be determined and eliminated. If the condition is caused by obesity, it must be reduced through exercise and a healthy and balanced diet. A thorough examination should also take place, as there may be other health conditions that could cause further problems in the future. Smokers must also take measures to prevent renewed phlebitis migrans. Smoking should be stopped first, supported by a change in diet and the introduction of positive habits.
In general, a healthy lifestyle with an appropriate diet and sufficient exercise can significantly reduce the risk of developing migratory phlebitis. Affected people should speak to a nutritionist and take appropriate steps with them and their family doctor to ensure vascular health.