A.R. Shipman; G.W.M. Millington


The British Journal of Dermatology. 2011;165(4):743-750. 

In This Article

Obesity, Vascular Disorders and Ulceration

Excess body weight puts extra stresses on the vascular system.[75,76] There is an association with varicose veins, possibly in part due to valve failure due to the high intra-abdominal pressures.[75] Venous insufficiency then leads to varicose eczema and ulceration.[76] Obese persons may have a higher pain threshold than the nonobese.[77] This decreased pain sensitivity might partly be the reason for the development of distal venous and pressure ulcers in obese individuals.[78]

Occasionally, severe obesity is associated with the development of massive necrosis of both subcutaneous fat and the overlying skin.[79] This may lead to secondary infection and ulcer formation.[76,80] The lymphatics are a fragile network of vessels that cause huge morbidity if they fail, with gross oedema and increased risk of infection due to the collection of protein-rich fluid in the tissues.[80,81] Lymphoedema presents as a soft, pitting swelling most commonly over the shins. It is often associated with obesity,[7,22] particularly the massive localized form of lymphoedema.[82]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.