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Primary Lower Extremity Telangiectasias — Relationship of Size to Color

Sclerotherapy remains the treatment of choice for primary telangiectasias of the lower extremities, a half century after the treatment was first devised. No substantial improvements have been made, largely because little or no attention has been paid to the underlying physiology. Evidence is presented that these vessels are dilated by virtue of their proximity to small arteriovenous communications. This would explain the response these vessels demonstrate when injected with sclerosing solutions, as well as the relationship between their size and their color, which is documented by objective and subjective measurements. Two novel methods of treating telangiectasias with existing sclerosing solutions are described, and the characteristics of an ideal sclerosant for these vessels are proposed.