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Superficial thrombophlebitis is a painful and sometimes disabling condition of veins just beneath the skin that commonly affects the legs, groin, and arms; it is often correlated to varicose veins. Superficial thrombophlebitis is also called superficial phlebitis. Its main mechanism is an inflammatory-thrombotic process, which may be secondary to infection, injury, blood disorders, or poor blood flow.
Normally, blood flows through vessels in a smooth, uninterrupted manner. When a person has predisposing factors, such as atherosclerosis or uneven thickening of the blood vessel wall, blood disorders such as leukemia or polycythemia, blood vessel trauma or simply poor blood flow, thrombus formation occurs. A thrombus is simply a blood clot that stays in one place within the blood vessel, which is a vein in this case. What makes this thrombus stick to the walls of the vein is an inflammatory reaction that increases that stickiness of platelets. The combination of inflammation and thrombosis leads to the typical symptoms of thrombophlebitis.
When superficial phlebitis occurs secondary to an infection, it is called septic thrombophlebitis. Usually, such an infection follows the use of intravenous catheterization among people who are undergoing intravenous drug treatment for other diseases. When there is no infection involved, superficial phlebitis is simply called sterile thrombophlebitis.
Regardless of the cause, a person who has superficial thrombophlebitis often experiences pain or tenderness over the affected area. This pain usually occurs with swelling. After sometime, a red streak might appear along the path of a vein, which normally appears as a blue or green vessel under the skin. If this red streak is palpated or felt along its length, it would have the consistency of an elevated hard cord.
A severe vein disease called deep vein thrombosis (DVT) should not be mistaken for superficial thrombophlebitis. DVT causes little or no inflammation, which is why it does not present with tender veins. Additionally, because DVT involves deep veins, it usually lacks skin manifestations.
This does not mean that a person with superficial phlebitis should be complacent. Studies show that people with superficial thrombophlebitis often have concomitant DVT. This is because both conditions have similar risk factors and mechanisms of development. Additionally, untreated superficial phlebitis could eventually invade the deeper veins, leading to postphlebitic syndrome, DVT, or even pulmonary embolism. Therefore, a person with superficial thrombophlebitis should be screened for DVT and pulmonary embolism and treated as soon as possible.
Treatment targets the cause and provides relief of symptoms. If there is an infection, antibiotics are given. To address the thrombosis and pain, low-molecular weight heparin (LMWH) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin are given. Other therapies that might help are regular walking, application of warm compresses, and use of compression stockings.