De "Revised" VCSS classificatie

None: 0

Mild: 1

Moderate: 2

Severe: 3

Pain

or other   discomfort (ie, aching, heaviness, fatigue, soreness, burning) Presumes   venous origin

Occasional pain or other

discomfort (ie, not restricting regular daily activities)

Daily pain or other discomfort (ie, interfering with but not preventing regular daily activities)

Daily pain or discomfort (ie, limits most regular daily activities)

Varicose veins   “Varicose” veins must be _3 mm in diameter to qualify in the standing   position.

Few: scattered (ie, isolated branch varicosities or clusters) Also   includes corona phlebectatica (ankle flare)

Confined to calf or thigh

Involves calf and thigh

Venous edema   Presumes venous origin

Limited to foot and ankle area

Extends above ankle but below knee

Extends to knee and above

Skin pigmentation   Presumes venous origin Does not include focal pigmentation over varicose   veins or pigmentation due to other chronic diseases

None or focal

Limited to

perimalleolar

area

Diffuse over lower

third of

calf

Wider distribution above lower third of calf

Inflammation More   than just recent pigmentation (ie, erythema, cellulitis, venous eczema,   dermatitis)

Limited to

perimalleolar

area

Diffuse over lower

third of

calf

Wider distribution above lower third of calf

Induration

Presumes venous   origin of secondary skin and subcutaneous changes (ie, chronic edema with   fibrosis, hypodermitis). Includes white atrophy and lipodermatosclerosis

Diffuse over lower

third of

calf

Wider distribution above lower third of calf

Active ulcer number

0

1

2

> 3

Active ulcer   duration (longest active)

N/A

< 3 mo

> 3 mo but < l y

Not healed for > l y

Active ulcer size   (largest active)

N/A

Use of compression therapy

0

Not used

1

Intermittent use of   stockings

2

Wears stockings most days

3

Full compliance: stockings

Pain or other discomfort (ie, aching, heaviness, fatigue, soreness,   burning)

The clinician describes the four categories of leg pain or discomfort   that are outlined below to the patient and asks the patient to choose,   separately for each leg, the category that best describes the pain or   discomfort the patient experiences.

None = 0

None

Mild = 1

Occasional pain or discomfort that does not restrict regular daily   activities

Moderate =2

Daily pain or discomfort that interferes with, but does not prevent,   regular daily activities

Severe = 3

Daily pain or discomfort that limits most regular daily activities

Varicose Veins

The clinician examines the patient's legs and, separately for each   leg, chooses the category that best describes the patient's superficial   veins. The standing position is used for varicose vein assessment. Veins must   be > 3 mm in diameter to qualify as “varicose veins.”

None = 0

None

Mild = 1

Few, scattered, varicosities that are confined to branch veins or   clusters. Includes “corona phlebectatica” (ankle flare), defined as > 5   blue telangiectases at the inner or sometimes the outer edge of the foot

Moderate =2

Multiple varicosities that are confined to the calf or the thigh

Severe = 3

Multiple varicosities that involve both the calf and the thigh

Venous Edema

The clinician examines the patient's legs and, separately for each   leg, chooses the category that best describes the patient's pattern of leg   edema. The clinician's examination may be supplemented by asking the patient   about the extent of leg edema that is experienced.

None = 0

None

Mild = 1

Edema that is limited to the foot and ankle

Moderate =2

Edema that extends above the ankle but below the knee

Severe = 3

Edema that extends to the knee or above

Skin Pigmentation

The clinician examines the patient's legs and, separately for each   leg, chooses the category that best describes the patient's skin   pigmentation. Pigmentation refers to color changes of venous origin and not   secondary to other chronic diseases.

None = 0

None, or focal pigmentation that is confined to the skin over varicose   veins

Mild = 1

Pigmentation that is limited to the perimalleolar area

Moderate =2

Diffuse pigmentation that involves the lower third of the calf

Severe = 3

Diffuse pigmentation that involves more than the lower third of the   calf

Inflammation

The clinician examines the patient's legs and, separately for each   leg, chooses the category that best describes the patient's skin   inflammation. Inflammation refers to erythema, cellulitis, venous eczema, or   dermatitis, rather than just recent pigmentation.

None = 0

None

Mild = 1

Inflammation that is limited to the perimalleolar area

Moderate =2

Inflammation that involves the lower third of the calf

Severe = 3

Inflammation that involves more than the lower third of the calf

Induration

The clinician examines the patient's legs and, separately for each   leg, chooses the category that best describes the patient's skin induration.   Induration refers to skin and subcutaneous changes such as chronic edema with   fibrosis, hypodermitis, white atrophy, and lipodermatosclerosis.

None = 0

None

Mild = 1

Induration that is limited to the perimalleolar area

Moderate =2

Induration that involves the lower third of the calf

Severe = 3

Induration that involves more than the lower third of the calf

Active Ulcer Number

The clinician examines the   patient's legs and, separately for each leg, chooses the category that best   describes the number of active ulcers.

None = 0

None

Mild = 1

1 ulcer

Moderate =2

2 ulcers

Severe = 3

> 3 ulcers

Active Ulcer Duration

If there is at least 1 active ulcer, the clinician describes the 4   categories of ulcer duration that are outlined below to the patient and asks   the patient to choose, separately for each leg, the category that best   describes the duration of the longest unhealed ulcer.

None = 0

No active ulcers

Mild = 1

Ulceration present for   < 3 mo

Moderate =2

Ulceration present for   3-12 mo

Severe = 3

Ulceration present for   > 12 mo

Active Ulcer Size

If there is at least 1 active   ulcer, the clinician examines the patient's legs, and separately for each   leg, chooses the cate gory that best describes the size of the largest active   ulcer.

None = 0

No active ulcer

Mild = 1

Ulcer < 2 cm in   diameter

Moderate =2

Ulcer 2-6 cm in diameter

Severe = 3

Ulcer > 6 cm in diameter

Use of Compression Therapy

Choose the level of compliance with medical compression therapy

None = 0

Not used

Mild = 1

Intermittent use

Moderate =2

Wears stockings most days

Severe = 3

Full compliance: stockings