Back issues No.2 - 2006 / Case Report  

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Peripheral Venous Hypertension Related to Arteriovenous Fistula for Hemodialysis- A Case Report
Wen-Yu Chang , Jiann-Woei Hwang , Hong-Tien Kuo , Hsiu-Hui Chiu , Gwo-Shing Chen , Chieh-Shan Wu
Dermatol Sinica 24:145-149,2006

Venous hypertension is a significant problem for patients under chronic
hemodialysis. Arterialization of the outflow venous system may induce this condition,
and result in impairment of arteriovenous access function, disabling upper extremity
edema, violaceous discoloration and hyperpigmentation, ulceration of the skin, and in
advanced cases, gangrene formation of the fingers and neuralgia. Histologic features
show thick-walled capillaries with plump endothelial cells in upper dermis, which are
compatible with the pattern of stasis dermatitis by chronic venous insufficiency. Early
awareness of these problems is crucial for dermatologists to prevent the extreme result
of gangrene formation.

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